DS-10-358 Miami Shores Village y
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
+ ' Phone: (305)795 -2204 F Y
JK
J�pr 4g J�3
Expiration: 09104/2010
Project Address Parcel Number Applicant
42 94 Street 1132060130330 MARIA JORGE
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
MARIA JORGE 42 94 Street
MIAMI SHORES FL 33138 -2820
Contractor(s) Phone Cell Phone Valuation: $ 1,000.00
HOME OWNER
Total Sq Feet: 0
Approved: In Review For Inspections please call:
Comments: (305)762 -4949
Date Approved:: In Review Available Inspections:
Date Denied: Inspection Type:
Type of Work: DRIVEWAY Additional Info: CLAY BRICK Final
Bond Retum : Classification: Residential Sidewalk
Landscaping
Foundation
Fees Due Amount Invoice # Invoice Total Amt Paid Amt Due
CCF $0.80 DS -3 -10 -37224
Education Surcharge $0.20
$129.60 $129.60 $0.00
Permit Fee $125.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $129.60
Building Department Copy
March 08, 2010 2
Miami Shores Village 3039T3
Building Department MAR 0 8 2010
1 60S N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 Y: . .....................
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING Permit No. V�
PERMIT APPLICATION Master Permit No.
"C 20
Perrmit Type _BUUMING RO -- - _ - ----- -- - -- -__- - - -_ - -- - - -_ - -_ __ -__ - _.
Owner's Name (Fee Simple Titleholder) ll�l �"�l �' �2 6 �- Phone # - 30,) 7 76_ -9 K
Owner's Address �2-- lVe 1 `f S
City M t H-W — State 2 �� R-- Zip 33! , 3 �
Tenant/Lessee Name Phone # _?o r 77
Email
Job Address (where the work is being done) 'f Z Al 3
City Miami Shores Village County Miami -Dade Zip 3 �
FOLIO / PARCEL #
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Name Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Contact Phone E -mail
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ Square / Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work:
UY1k)UffE:: 'AW4 V
Submittal Fee $ Permit Fee $ L CCF $ 4 CO /CC $
G i
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ ' Radon $ DPBR $ Bond $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $
See Reverse side
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zap
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for!,ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES; BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will °'be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice Of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
�- -
Signature Signature
Owner or Agen Contractor
wledged befor me this The foregoing instrument was acknowledged before me this
The foreg g instrument was a�kn
s
day o� 20 by day of , 20 _, by ,
who is p rsonally k4own to me or who has produced who is personally' known to me or who has produced
1'1. lAtfication and who did take an oath. as identification and who did take an oath.
NOTAR UBLIC. NOTARY PUBLIC:
Sign: �a:!��1 �,� 5ign,
Print: o
A•� e Print:
My Commission Expires: M , t 4� My Commission Expires:
'�••� „�
APPROVED BY Plans Examiner C, Zoning
Engineer` Clerk checked
(Revised 07 /10 /07)(Revised 06/1012009)
M iami Shores V illage
�. Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax; (305) 756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: A —t A- e- -ru DATE;
ADDRESS: VL Ne 9e v
Do hereby petition the Village of Miami Shores to act as my own contraft pursuant to the laws of the State of Florida, F.S 489.103(7).
And I have read and understood the following disclosure statement, which entities iris to work as my on contractor, I further
understand that I as the owner must appear in person to complete all applications.
State Law requires construction to be done by a licensed contractor. You have applied fora permit under an exception to the law. The
exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must
supervise the construction yourself. You may build or improve a one - family or two-family residence. You may also build or improve a
commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building Must be for your own use and
occupancy. It may not be built for sale or lease. tf you sell or lease a building you ham built yourself within one year after the
construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire
an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state
law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your
supervision and must be employed by you, which means that you must deduct F.I.CA and with - holdings tax and provide workers'
compensation for that employee, all as prescribed by law. Your construction must comply with all 801 le laws, ordinances,
buildings codes and zoning regulations.
Please read and initial each paragraph.
1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner- builder
permit under an exemption from the law. The exemption spedfies that 1, as the owner of the property Imo, may act as my own
contractor with certain restr cictions even though I do not have a license. RR
N
' Initial �
2. 1 understand that building permits are not required to be AnOd by a property owner unless he or She is responsible for the
construction and is not hiring a licensed contractor to assume responsibility.
Initial
3. 1 understand that as an miner builder, I am the responsible party of record on a permit I understand that I may protect myself
from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own
name. I also understand that the contractor is required by law to be 111consed in Florida wW' to list his or license numbers on
permits and contracts.
Initial
4. 1 understand that I may build or improve a one family or two-family resdderxe or a farm, outbuilding. I may also build or'improve
a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may
not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved
myself is sold or leased within 1 year after the construction is complete, the lair will presume that I built or substantially
improved it for sale or lease, which violates the exemption.
Initial �
5. 1 understand that as the owner-builder, I must provide direct onsite supervision of the construction.
Inuttal C
6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or
residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or
municipal ordinance.
Initial
7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that
erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner - builder,, may be held
liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while
working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully- aging as an
owner- builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
Initia
8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to
perform the work being done. Any person working on my building who is not licensed must work under my direct supervision
and must be employed by me, which' means that I must comply with laws requiring the withholding of federal income tax and
vial security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for
the employee. I understand that my failure to follow these may subject to serious financial risk.
9. 1 agree that, as the party legally and financially responsible for this proposed Construction "activity, I will abide by all applicable
laws and requirement that govem owner- builders as well as employers. I also understand that the
Construction must amply with all applicable laws, ordinances, building codes, and zoning regulations.
lnmw :� Q
10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the
United States Small Business Administration, and the Florida Department of Revenues. I also understand that 1 may contact the
Florida Construction Industry Licensing Board at 850.487.1395 or http: /Mrww.myWdaiice se.com/d�r/ MEcithrndex.html
11. 1 am aware of, and consent to; an owner- builder building permit applied for in myname and understands that 1 am the party
legally and financially responsib a for the proposed construction activity at the following address:
r
An
Initial
12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I
have provided on this disclosure.
Initial
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a
license, the Corstr4uction Industry Uoensing Board and Department of Business and Pro_ fessional Regulation may be unable to
assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to
understand that, if an unlicensed contractor or employee of an individual or firm is Injured while working on your property, you may
be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for
verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage.
Before a building permit can be issued, this disclosure statement must-be completed and signed by the property coroner and
returned to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the
notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when
the permit is issued.
Was acknowledged before me this day of 14" - , 20 f v
By who was personally known to me or who has
Produced there License or I 4idenfification.
OWNE NOTA Z.
Sod
®..•
Planning and Zoning Criteria
50 Miami Shores Village Permit NO. DS
may. M 10050 N.E. 2nd Avenue a
Miami Shores, FL 33138 -0000 s
Phone: (305)795 -2204 Fax (305)758 -8972
•CORD''
Issue Date 3/812010 Expims•31 /2010
Folio Number) 132060130330
Owner's Name: MARIA JORGE Owner's Phone:
Job Address: 42 94 Street Total Square Feet: 0
Miami Shores, FL 33138- Total Job Valuation: $ 1,000.00
Contractor(s) Phone Primar C
HOME OWNER Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 3/8/2010: Yes
Comments: AFTER THE FACT PERMIT RELATES TO PERMIT 05 -561
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R�std '1Cra iX} g p ,OT 7 AND HE EAST 1/2 OF
x z < Z s No. 42 M `� i>1 i � C•;
M O ? �{ .g�" LEGAL DESCRIPTION: Lot 8 Block 3 r c
t Q 6► �° v. 6 , .. �?� Subdivision AN AMENDED .€ LAT OF MIAMT. SNORE•.,
N r u ' 3 �� �`
according to the Plat thereof as Recorder in Plat Book {�
O u 1 t^ r 1 U at Page � —of the Public Records of D A U T Cou Fl o r ida.
fn 7 u un to Ida.
(i�.filA C. TORG`
Ul W it ij! z �- 4 v, � � H- 2 NE 94th STREET
4= SURVEY FOR: �, - ..:,. F - q c= U c; ,` ' "r'orVte C .,I MIA SHORES, FLORIDA
Q tl >.»Raocr
C' -3 F - 4 � i � � I HEREBY CERIFY: That the survey of the above captioned properly was completed under
m supervision and /or direction, to the best of m knowl
tIy O w y ti_ Y Y dge and belief;
F 1:-+ 0 � a this survey meets or exceeds the Minimum Technical Standards set forth
Q $ 0 O U 1 1 1 by the Florida Board of Land Surveyors in Chapter 61 G17 Flori
y, cry f , Administrative Code, pursuant to Section 427.027, Florida Statutes.
f ,
W e o q) 3 p
ZCl U I E - cr o � . �c Q_ � Waldo F. Paez
r v 01 i i cti
Registered Land Surveyo No. 284
State of Florida
1 - There may be additional restriction that ore not shown on this survey that may be
found in the Public Records of this county.
2 - Examination of ABSTRACT OF TITLE will have to be made to determine recorded i r 1 11 111 ?° ��������011 INC.
Instruments, if any affecting property. Lp'
x - -- x - ; ui LAND SURVEYORS LAND PLANNERS
3- Location and identlflcatlon of.UtiNties If any, are shown In accordance with Recorded � i-" x - -- ri
Plat.
12888 S.W. 53rd ST. PHONE: 223 - 4907 MIAMI, FLORIDA
4 Ownership is subject to OPINION OF TITLE. """"" — - "`
-5- T e of Suer -? - ;4 i cord ` �d m ou 15"' t u tlllty SCALE: 1 "= 20 ' APPROVED BY DRAWN BY: _'� • 13 .
YP Survey: "BOU SURVEY"
M i r f' DATE: i - 5 - r3 7 PAEZ FB: S ri M T C HPG:
6- This Survey is not valid unless signed and sealed by the Surveyor of Record. 10, 1~S Vumer 1> ` { (l j
7- Bearings Neon ore referred to an assumed value ot. ` "'— °" _ REVISED
for the
said bearing. Is identical with the plat of record
8 - 2. Elevat 1929 if shown are referred to National Geodetic Vertical Datum of Mean Sea
Leval COMMUNITY NUMBER PANEL NUMBER SUFFIX DATE OF FIRM IND:'X FIRM ZONE BASE FLOOD ELEVATION DRAWING NUMBER WMIkAr
Lo cation In dex: , �i
c . cation In ex: ,7 3 -- Elevation= (. 2 (} a 5 ? 7 O 3 `� X
i7K��H OF SURV '37 -4313
a Lo
MAR 0 8 2010
P y
• w mmmmmo�m
i
I
LPIT
Miami Shores Village
APPROVED BY DATE
ZONING DEPT A
BLDG DEPT d/ C.�
SUBJECT TO CCMPLIANCE WITH ALL FEDERAL
STATE AND CGUN'tY RULES AND REGULATIONS
tf
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP 137353 Pe N DS -3 -10 -358
Scheduled Inspection Date: March 09, 2010 Permit Type: Driveways /Sidewalks /Slabs
Inspector: Bruhn, Norman
Inspection Type: Final
Owner: JORGE, MARIA Work Classification: New
Job Address: 42 NE 94 Street
Miami Shores, FL 33138 -
Phone Number
Parcel Number 113206013033
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
AS PER BP 05 -561. THIS PERMIT IS TO RENEW OLD
ONE. NEW CLAY BRICK DRIVEWAY ON FRONT OF THE
PROPERTY
Inspector Comments
Pass
Failed
Correction ❑
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 08, 2010 For Inspections please call: (305)762 -4949 Page 26 of 34
Miami Shores Village Build Permit
10050 NE 2nd Avenue *' too
Phone: 305 - 795 -2204 Permit Number: BP2005 -561
Printed: 5/10 12005 Page 1 of 1
Applicant: MARIA JORGE
Owner: JORGE MARIA
JOB ADDRESS: 42 NE 94 ST
Contractor DECORATIVE MASONRY INC Contractor's Address: 842 N. E. 99 St.
Local Phone: (305)757 -7765
Parcel # 1132060130330 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 7 & E1/2 OF LOT 8 BLK 3 LOT SIZE
Fees: Description Amount
FEE2005 -5669 Building Fee $125.00
FEE2005 -5670 CCF $1.80 Total Fees $435.40
FEE2005 -5671 Notary Fee $5.00 Total Receipts: $0.00
FEE2005 -5672 Training and Education Fee $0.60
FEE2005 -5673 Scanning Fee $3.00 Gr— �BE3G
FEE2005 -5674 Builders Bond $300.00
Total Fees: $435.40
'JUL 15 PAI
Permit Status: APPROVED Permit Expiration: 10/16/2005 Construction Value: $2,400.00
Work: INSTALL CLAY BRICK DRIVEWAY
Signed: (INSPECTOR)
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Miami Shores. Village
Building Department
10050 N.E.2nd Avenue, Nami Shores, Florida 33138
Teh (305) 795.2204 Fax: (305) 756.8972
BUILDING a Permit No. .opus° s I
PERMIT APPLICATION a Master Permit No.
FBC 2001
Permit Type (circle): uildin Ele trical _s__ Mechanical Roofing
Owner's Name (Fee Simple Titleholder) e r Phone #
Owner's Address �� .
city State �2 Zip � v
Tenant/Lessee Nam Phone #
Job Address (where the work is being done) !2
City 1Vliarni Shores Villa e County Miami-Dade Zip
Is Building Historically Designated YES NO_
Contractor's Company Name �,�s Phone # ��� —�._
Contractor's Address
d
City State
Qualifier
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit Square Footage Of Work:
Type of Work: ❑Addition Alteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work: E'
Submittal. Fee $ Permit Fee $ CCF $ CO /CC
Notary $ TraininglEducation Fee $ c Technology Fee $
Scanning $ Radon $ Zonin Bond $ �--�
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side) �J "
Bonding Company's Name (if applicable)
Bonding Company's Address
.City State _ Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC.....
OWNER'S AFFIDAVIT: I certify . that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant:. Asa condition to the issuance of a building permit with an estimated value exceeding $2S00, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building per Ys •issued In the absence of such posted Lice, the
Signature S' Cof inspection will not be approved and a reinspection fee will be charged.
a�/ � Gam- �
Owner or Ag t Contractor /'
The foregoing instrument was ackno ledged before we this The for was ac edged be are e thi (`
y�
day of 20 y VI day of
20, by
wh is pe orally kno o m or who has pr used who is pe orally kno t me or who has produce
Aside tification and who d take an oath id tifi and who : tae did- a 3
a&bath.
NOTARY PUBLI .` cogY ?os : el/Ia NOTARY PUB IC:
S ign. NA . = CO a lissl ' �® �. Slgll.
OF
Print:
onded ru Print: V
T
on Co., 7;:
My Commissio Expires: My Commi ion Expires.
(Certific to of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
APPLICATION APPROVED BY: 2 5 20 plans Ewe.
Engineer
®� Zoning
Chc 12J15103
i
MIAMI SH VILLA 0
BUILDING DEPARTMENT cy
305 -795 -2204
Bui ding Inspection Request
Date F q
Type Insp'nFA K rj l f
Permit No. ckA o
Name
Address Al
Company JP '(X
Phone # °
Inspection Date I
Approved ❑
Correction
Re- Insp'n Fee v '
A
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ured 15"
FOUnd 1/2. Fipe
p �' �j�pana (L i3
- ( LOCATION SKETCR -• N.T.S.
CIA rq !
lanter
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V I 9F 2210'
d) '� tlki H w � .._ �
Q i C3C1. �tOr r
( e 7 < ef T HE EAST 1/2 t7)µ
Q " ti E� pp i I "` No. 42 m � � ! � LOT 7 AND c�
be U
A p �; o ` I 40. 00' � i� LEGAL DESCRIPTION: Lot Bio tik 3 r c
• V� ` �, rte, ! Subdivision AN AMENDED PLAT OF MIAM -1 S,TORF..
I _ ' -I: °" according to the Plat thereof as Recorder in Plat Book 10
ej aQ ?r cJ i .i5' Q} DADS Count Florida.
tV� at Page - — of the Public Records of
p ® � Z V; k e _ .`` a> bt M XIiT?� C . TORE`
LL SURVEY FOR: 42 NE 94t STREFT
ej
�� C-'• L3 Li C} - y ? � * ��,. pe7P oe -� MIAi1:t SHORES, FLORIDA
tali E I HEREBY CERIFY: That the survey of the above captioned property was completed under
R , ( i, my supervision and/or direction, to the best of my knowledge and beiref;
E- E 0 this survey meets or exceeds the Minimum Technical Standards set forth
�> by the Florida Board of Land Surveyors in Chapter 61 G17 Flortdc� ry
Administrative Code, pursuant to Section 427.027, Florida Statutes.
E ✓' f
C - ) i DELTA
+- a <°
L
WWI
0 E E' ai 40 : Waldo F. Paez
Registered land Surveyo No.
State of Florida
1. - There may be additional restriction that are not shown on this survey that may �1 fli„�" be
found in the Public Records. of this county.
2 Examination of ABSTRACT OF TITLE will have to be made to determine recorded
Instruments, If any affecting property. i i 20, ' C ■ INDELTA
3 - Location and Identification of.Utllttles If any, are shown In accordance with Recorded } x- -x x- 1 �c /AND SURVEYORS LAND PLANNERS
Plat, �� _— - -- ° -r
.12888 S.W. 53rd ST. PHONE: 223 - 99E17 MIAMI, FLORIDA
4 - Ownership is subject to OPINION OF TITLE.
s - Type of survey: "BOUNDARY SURVEY" R e co r d ,
ij✓cit�'r i Utilttc� SCALE: 1 2 APPROVED BY DRAWN BY: • B
+R f �
6- This Survey is not valid unless signed and sealed by the Surveyor of Record. it eter � i i�'
A ll
e , - � o!e RATE: 5-5-97 PAEZ FB: > ri F �' C iIPG:
7- Bearings hereon are referred to an assumed value o# - i@ i�a Vem�nt � REVISED
for the
sold bearing.is Identical with the plat of record
8 - Level, If shown are referred to National Geodetic Vertical Datum of Mean Sea
Level, 1929 COMMUNITY NUMBER PANEL NUMBER SUFFIX DATE OF FIRM INDEX FIRM ZONE BASE FLOOD ELEVATION DRAWING NUMBER
Benchmark: Elevation= t} } 7 3 _ : 9 , 1 ) 7 - el 3
a Location Index: 1 206 52
00 00''
74�
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l oll . M i a mi 0rej t e
10050 N.E. SECOND AVE.
4 MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305).795-2207
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS,
l �® hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description/folio#:
Lot Block Subdivision
Tax Folio #:
requests permission to install:
Asphalt, concret rick pave
[ ] Landscaping
[ ] Other
within the public road right of way of ���6
(address)
IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows:
I. To maintain and repair, when necessary, the above - mentioned item(s) installed within the dedicated right
of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said
items within public right of way including restoration of street by reason of the Owner's failure to do so,
such expense shall be paid by the Owner or shall constitute a lien against the above described property
until paid.
2. The owner does hereby agree to indemnify and hold Miami Shores Village or dade County harmless from
any and all liability, which may rise by virtue of permitting the installation of these items within the public
right of way.
3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days
notice by the Village to do so. Failure to comply with this notice will result in the Village causing the
item(s) to be removed and alien being placed on the property and/or assessed against the Owner for all
costs incurred in the removal and disposal of the item(s).
4. The undersigned further agrees that these conditions shall be deemed a covenant running with*the land and
shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such
time,as this obligation has been canceled by an affidavit filed in the Public records of Dade County, Florida
by the Village Manager of Miami Shores Village (or his fully authorized representative).
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this day of e , ®�
1
• (o er)
SIG ED, SEALED AND DELIVERED in the presence of-
how e
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