530 NE 96 St (15)1-te.Eif w 4�rk
rig loop .
Jeb Bush
Governor
Mr. Michael Meyer
530 N.E. 96 St
Miami Shores, Fl 33138
RE: OSTDS
Lot: 9 Block: 54 Subdivision: Miami Shores
Property Address : 530 N.E. 96 St
Date of issue: 04/08/04
Dear Applicant:
Paul Ledel Andre, P.E., C.E.H.P.
Profession. I Engineer III
Lillian Rivera RN; MSN Administrator
occf) X0(0
Please be advised that the Onsite Sewage Treatment and Disposal System construction permit issued by
this department for the above referenced property has expired.
A system construction permit is valid for a period of eighteen (18) months from the date of issue.
However, if building construction has commenced the permit shall be valid for an additional ninety
(90) days beyond the eighteen (18) months expiration date.
A new construction permit must be obtained after this period of time in order to install an onsite sewage
treatment and disposal system on this property. No inspection or approvals can be provided without a
valid permit.
In addition, the Miami -Dade County or the municipality may not authorize the occupancy of the
building unt e department approves the final installation of the onsite sewage treatment and
disposal sy em i ' ccordance with chapter 381.0065(4).
If you hav: any quests ins on this matter, please call our office at (305) 513 — 3459.
cc. Permit file
Claudio Grande Building Official of City of Miami Shores
Samir Elmir, M.S., P.E. , Environmental Administrator
Miami -Dade County Health Department/Environmental Health
1725 N.W. 167 Street, Miami, Florida 33056
TEL (305) 623 -3500 • FAX (305) 623 -3502
Email: samir_elmir @doh.state.fl.us
Website: www.dadehealth.org
Rony Francois, M.D., M.S.P.H., PhD
Secretary
November 15, 2006
Permit No. 04- 0616 -N
Folio. 11- 3206 -014 -0691
Expiration Date: 10 /08/05
STATE OF FLORIDA
DADE COUNTY HEALTH DEPARTMENT
Septic Tank Division
7755 N.W. 48 Street, Miami, Florida 33166
MIAMI Ft 33 ii.
Mr. Claudio Grande
Building official
Bldg & Zoning / City of Mia Shores
10050 N.E. 2nd Avenue
Miami Shores, Florida 33138
1 1 1 1 1 111111111111 'III 11i1111111 Anti 1 1 If 11111111111111111
2CO5
CONSTRUCTION PERMIT FOR:
[ X ]New System [ ]Existing System [ ]Holding Tank [ ] Innovative Other
[ ]Repair [ ]Abandonment [ ]Temporary [ NA ]
APPLICANT: Meyer, Michael AGENT: OWNER,
PROPERTY STREET ADDRESS: 530 NE 96 St Miami Shores FL 33138
LOT: BLOCK: 54 SUBDIVISION: Miami Shores
[Section /Township /Range /Parcel No.]
PROPERTY ID #: 11- 3206 - 014 -0691 [OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC
DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME
PERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT,
REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS
PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM
COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 1050 ]Gallons SEPTIC TANK
A [ 0 ]Gallons
N [ 0 ]GALLONS GREASE INTERCEPTOR CA
K [ 0 ]GALLONS DOSING TANK CAPACITY
OTHER REMARKS:
SPECIFICATIONS BY: Andre, Paul
APPROVED BY: Andre, Paul
DATE ISSUED: 4/8/04
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CENTRAX #: 13 -SG -19646
DATE PAID:
FEE PAID : $
RECEIPT .
OSTDSNBR : 04 -0616- -N
MULTI - CHAMBERED /IN SERIES: [Y ]
LTI- CHAMBERED /IN SERIES: [Y ]
0 ]DOSES PER 24 HRS # PUMPS[ 0 ]
D [ 571 ]SQUARE FEET PRIMARY DRAINFIELD SYS
R [ 0 ]SQUARE FEET SYSTEM'
A TYPE SYSTEM: [ Y ]STANDARD [ N ]FYLLED [ N ]MOUND [ N ]
I CONFIGURATION: [ N ]TRENCH [ Y ]BED [ N ]
N
F LOCATION TO BENCHMARK: 8.14' NGVD/ NW Corner Sidewalk
I ,ELEVATION OF PROPOSED SYSTEM SITE [ 5.4 ] [ INCHES ] [ BELOW]BENCHMARK /REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 23.4 ] [ INCHES ] [ BELOW]BENCHMARK /REFERENCE POINT
L
D ,FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 68.3 ] INCHES
1- "Soil replacement required.
2- Install 1050 gals. category -3 septic tank equipped with an
approved filter.
3- The licensed contractor installing the system is responsible for
installing the minimum category of tank in accordance with sec.
64E-6.013(3)(f), FAC.
4- Install 571 sq. ft. of drainfield in bed configuration.
5- Install 42" of slightly limited soil under the bottom of
drainfield.
6- Perimeter of excavation shal •e 2 ft der and longer than the proposed absorption
bed.
DH 4016, 03/97 (Obsoletes previous editions which may not be used)
TITLE: -
TITLE: Professional Engin Dade CHD
EXPIRATION DATE: 10/8/05
Dmr.r, 1 l.F 7
CONSTRUCTION PERMIT FOR:
[ X ]New System [ ]Ex
[ ]Repair [ ]Ab
APPLICANT: Meyer, Michael
PROPERTY STREET ADDRESS: 530 NE 96 St Miami Shores FL 33138
LOT: 9 BLOCK: 54
[Section /Township /Range /Parcel No.]
PROPERTY ID #: 11- 3206 - 014 -0691 [OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC
DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME
PERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT,
REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS
PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM
COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 1050 ]Gallons SEPTIC TANK
A [ 0 ]Gallons
N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY
K [ 0 ]GALLONS
D [ 571 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ 0 ]SQUARE FEET SYSTEM
A TYPE SYSTEM: [ Y ]STANDARD [ N ]FILLED
I CONFIGURATION: [ N ]TRENCH [ Y ]BED
N
F LOCATION TO BENCHMARK: 8.14' NGVD/ NW Corner Sidewalk
I .ELEVATION OF PROPOSED SYSTEM SITE [ 5.4 ] [ INCHES ]
E BOTTOM OF DRAINFIELD TO BE [ 23.4 ] [ INCHES ]
L
D .FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 68.3 ] INCHES
OTHER REMARKS:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
isting System [ ]Holding Tank [ ] Innovative Other
andonment
]Temporary [ NA ]
AGENT: OWNER,
SUBDIVISION: Miami Shores
DOSING TANK CAPACITY [ 0
1- Soil replacement required.
2- Install 1050 gals. category -3 septic tank equipped with an
approved filter.
3- The licensed contractor installing the system is responsible for
installing the minimum category of tank in accordance with sec.
64E- 6.013(3)(f), FAC.
4- Install 571 sq. ft. of drainfield in bed configuration.
5- Install 42" of slightly limited soil under the bottom of
drainfield.
6- Perimeter of excavation shall
bed.
SPECIFICATIONS BY: Andre, -. ' TITLE:
APPROVED BY: Andre, Paul TITLE: Professional Engin
DATE ISSUED: 4/8/04 EXPIRATION DATE: 10/8/05
DH 4016, 03/97 (Obsoletes previous editions which may not be used)
]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 ]
[ N ]MOUND [ N ]
[ N ]
[ BELOW ] BENCHMARK/REFERENCE POINT
[ BELOW BENCHMARK /REFERENCE POINT
t wider and longer than the proposed absorption
P- c .
CENTRAX #: 13 -SG -19646
DATE PAID:
FEE PAID : $
RECEIPT .
OSTDSNBR : 04 -0616- -N
MULTI - CHAMBERED /IN SERIES: [Y ]
MULTI - CHAMBERED /IN SERIES: [Y ]
Dade
CHD
Dmr.o 1 ,,f ')
APPLICANT: Meyer, Michael
AGENT: , OWNER
LOT: 9
•
PROPERTY SIZE CONFORMS TO SITE
TOTAL ESTIMATED SEWAGE FLOW:
AUTHORIZED SEWAGE FLOW:
UNOBSTRUCTED AREA AVAILABLE:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
BLOCK: 54 SUBDIVISION: Miami Shores
BENCHMARK /REFERENCE POINT LOCATION: 8.14' NGVD/ NW Corner Sidewalk
CENTRAX #: 13 -SG -19646
OSTDSNBR : 04- 0616 -N
ID #: 11- 3206 - 014 -0691
OWNER
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S
MUST PROVIDE REM NUMRRR AND SIGN AND SEAT, EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PLAN:[X]YES [ ]NO NET USABLE AREA AVAILABLE: 0.16 ACRES
400 GALLONS PER DAY (64E -6, TABLE 1]
400 GALLONS PER DAY [1500GPD /ACRE OR 2500GPD /ACRE]
1146 SQFT UNOBSTRUCTED AREA REQUIRED: 1143 SQFT
ELEVATION OF PROPOSED SYSTEM SITE IS 5.40 [ INCHES ] [ BELOW ]BENCHMARK /REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES:
SURFACE WATER: N/A FT DITCHES /SWALES: N/A FT NORMALLY WET? [ ]YES [ X ]NO
WELLS: PUBLIC: N/A FT LIMITED USE: N/A FT PRIVATE: N/A FT NON - POTABLE: N/A FT
BUILDING FOUNDATIONS: 10 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 11 FT
SITE SUBJECT TO FREQUENT FLOODING: [ ]YES [ X ]NO
10 YEAR FLOOD ELEVATION FOR SITE: 0 FT NGVD
SOIL PROFILE INFORMATION SITE 1
Munsell # /Color Texture
1nYR -4 /1 -n (.Y Randy Lnam
1OY12 R /1 - WR Onlitin Liman
USDA SOIL SERIES: 15 Urban land
Depth
n to 19
19 to 79
to
to
to
to
to
to
10 YEAR FLOODING? [ ]YES [ X ]NO
SITE ELEVATION:
0 FT NGVD
SOIL PROFILE INFORMATION SITE 2
Munsell # /Color Texture
1nVR -4 /1 -n ay
1nYR- H /1 -WF.
Sandy LOAM
nn1iti- Limps
USDA SOIL SERIES: 15 Urban land
Depth
n to 1 Fi
1 Fi to 77
to
to
to
to
to
to
OBSERVED WATER TABLE50.00 INCHES [ BELOW ] EXISTING GRADE TYPE: [ PERCHED
ESTIMATED WET SEASON WATER TABLE ELEVATION:50.00 INCHES [ BELOW ] EXISTING GRADE.
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: 0.0 INCHES
SITE EVALUATED BY: John Capers
SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING Replacement/0.70 DEPTH OF EXCAVATION:68.3 INCHES
DRAINFIELD CONFIGURATION: [ ]TRENCH [ X ]BED [ ]OTHER (SPECIFY)
REMARKS /ADDITIONAL CRITERIA:
DH 4015, 03/97 (Obsoletes previous editions which may not be used)
(Stock Number: 5744- 003 - 4015 -1) (ostds eval 4015 -3)
DATE: 3/2/04
Page 3 of 3
APPLICANT: Meyer, Michael
AGENT: , OWNER
LOT: 9 BLOCK:
PROPERTY SIZE CONFORMS TO SITE
TOTAL ESTIMATED SEWAGE FLOW:
AUTHORIZED SEWAGE FLOW:
UNOBSTRUCTED AREA AVAILABLE:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
54 SUBDIVISION: Miami Shores ID #: 11- 3206 - 014 -0691
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S
MUST pROVIDF REGISTRATION NUMBER AND SIGN AND SEAT, EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PLAN:[X]YES [ ]NO NET USABLE AREA AVAILABLE: 0.16 ACRES
400 GALLONS PER DAY [64E -6, TABLE 1]
400 GALLONS PER DAY [1500GPD /ACRE OR 2500GPD /ACRE]
1146 SQFT UNOBSTRUCTED AREA REQUIRED: 1143 SQFT
BENCHMARK /REFERENCE POINT LOCATION: 8.14' NGVD/ NW Corner Sidewalk
CENTRAX #: 13 -SG -19646
OSTDSNBR : 04- 0616 -N
OWNER
ELEVATION OF PROPOSED SYSTEM SITE IS 5.40 [ INCHES ] [ BELOW ]BENCHMARK /REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES:
SURFACE WATER: N/A FT DITCHES /SWALES: N/A FT NORMALLY WET? [ ]YES [ X ]NO
WELLS: PUBLIC: N/A FT LIMITED USE: N/A FT PRIVATE: N/A FT NON- POTABLE: N/A FT
BUILDING FOUNDATIONS: 10 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 11 FT
SITE SUBJECT TO FREQUENT FLOODING: [ ]YES [ X ]NO
10 YEAR FLOOD ELEVATION FOR SITE: 0 FT NGVD
SOIL PROFILE INFORMATION SITE 1
Munsell # /Color Texture Depth
1 nVR -4/1 -fl (Y Sandy T.nam 0 to 19
1 OYR - R /1 - W l i ti n T.imaa 19 to 79
to
to
to
to
to
to
USDA SOIL SERIES: 15 Urban land
SITE EVALUATED BY: John Capers
DH 4015, 03/97 (Obsoletes previous editions which may not be used)
(Stock Number: 5744- 003 - 4015 -1) [ostds eval 4015 -3]
10 YEAR FLOODING? [ ]YES [ X ]NO
SITE ELEVATION: 0 FT NGVD
SOIL PROFILE INFORMATION SITE 2
Munsell # /Color Texture Depth
1 nYR -4/1 -fl GY Sanriy T.nam n to 1A
1 OYR -R /1 - W F , nnl i ti r• T.i maq 1A to 79
to
to
to
to
to
to
USDA SOIL SERIES: 15 Urban land
OBSERVED WATER TABLE50.00 INCHES [ BELOW ] EXISTING GRADE TYPE: [ PERCHED
ESTIMATED WET SEASON WATER TABLE ELEVATION:50.00 INCHES [ BELOW ] EXISTING GRADE.
HIGH WATER TABLE VEGETATION: ( ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: 0.0 INCHES
]
SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZINGReplacement/0.70 DEPTH OF EXCAVATION:68.3 INCHES
DRAINFIELD CONFIGURATION: [ ]TRENCH [ X ]BED [ ]OTHER (SPECIFY)
REMARKS /ADDITIONAL CRITERIA:
DATE: 3/2/04
Page 3 of 3
APPLICANTS
AGENT:
PROPERTY ADDRESS:
LOT
=zsss asss sss== axxasss Gass::: sssss sss sssss ssssss ss: an:::: :szssssa�ssss::szsszsssssssaasz
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
=== x= a= as = = = sc=========smarasmssammswagatm=======================
l
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I
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I
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I
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND
CONSTRUCTION INSPECTION AND
BLOCK: SUBDIVISION:
TANK INSTALLATION
[01] TANK SIZE [1] " [2]
[02] TANK MATERIAL
[03] OUTLET DEVICE
[04] MULTI- CHAMBERED [ Y'/ N ]
[05] OUTLET FILTER
[06] LEGEND
[07] WATERTIGHT
[08] LEVEL
[09] DEPTH TO LID
DRAINFIELD INSTALLATION
[ 10]
[11]
[
[13]
[
(15]
[16]
[17]
[18]
[19]
[20]
AREA [1] r 1 ,. [2]
DISTRIBUTION BOX _
NUMBER OF DRAINLINES
DRAINLINE SEPARATION
DRAINLINE SLOPE
DEPTH OF COVER
ELEVATION [ABOVE /BELOW] BM
SYSTEM LOCATION
DOSING PUMPS
AGGREGATE SIZE
AGGREGATE EXCESSIVE FINES
[21] AGGREGATE DEPTH
FILL
[22]
[
[24]
[25]
[26]
/ EXCAVATION MATERIAL
FILL AMOUNT
FILL TEXTURE
EXCAVATION DEPTH
AREA REPLACED
REPLACEMENT MATERIAL
SQFT
HEADER
SETBACKS
[ I [27] SURFACE WATER FT
[ ] [28] DITCHES FT
[ ] [29] PRIVATE WELLS FT
[ ] [30] PUBLIC WELLS FT
[,_] [31] IRRIGATION WELLS FT
[ ] [32] POTABLE WATER LINES FT
[ ] [33] BUILDING FOUNDATION FT
[ ] [34] PROPERTY LINES FT
[ ] [35] OTHER FT
ul
PERMIT NO. ; e i" le f •
DATE PAID:
DIPOSAL SYSTEM FEE PAID:
FINAL APPROVAL RECEIPT #:
PROPERTY ID # : r '
FILLED / MOUND SYSTEM
[36] DRAINFIELD COVER
[37] SHOULDERS
[38] SLOPES
[39] STABILIZATION
ABANDONMENT
[49] TANK PUMPED _ / /
[50] TANK CRUSHED & FILLED
ADDITIONAL INFORMATION
[40] UNOBSTRUCTED AREA
[41] STORMWATER RUNOFF
[42] ALARMS
[43] MAINTENANCE AGREEMENT
[44] BUILDING AREA
[45] LOCATION CONFORMS WITH SITE PLAN
[46] FINAL SITE GRADING
[ 47 ] CONTRACTOR
[48] OTHER
EXPLANATION OF VIOLATIONS / REMARKS:
[ I
[ ]
[ I
[ ]
CONSTRUCTION [APPROVED/DISAPPROVED]:
FINAL SYSTEM [APPROVED /DISAPPROVED]: k "
/
DH 4016, 10/97 (Previous Editions May As Used)
INSTALLER / CONTRACTOR
PT 1: Applicant
PT 2: Installer /Contractor
PT 3: Building Department
PT 4: Health Department
CHD DATE:
CHD DATE
Page 2 of 3
PERMIT NUMBER:
APPLICANT:
AGENT:
MAILING ADDRESS:
LOT, BLOCK, SUBDIVISION
PROPERTY ID#:
TANK SIZE (gallons)
TANK MATERIAL (concrete, fi:• _: rglass, etc)
OUTLET FILTER (manufaciurer, make, model)
LEGEND (manufacturer code)
DRAINFIELD AREA (square feet)
DISTRIBUTION BOX / HEADER (check box)
NUMBER OF DRAINLINES (number installed)
SYSTEM ELEVATION (in relation to )
DOSING PUMPS (number install)
SETBACKS (record actual set
SETBACKS OT! .E: (ns require_.)
STABILIZAT CON (date stabilized)
CONTRA.
ADDI
ABAN
TANK
EXP
CONS
FINAL
Final
compile
cksinft)
Permit tracking number signed by CH
Property owner's full name.
Property owner's legally autholac representative.
P.O. box or street mailing addrozs for applicant or agent.
Lot, Block and Subdivision for COt or
27 character number for pro ,• trty. (pre ;•: = rty appraiser ID ft OF G "S !cc cn)
COUNTY HEALTH DEPARTMENT CHECKS [X] ITEMS NOT IN COI PLCANCE WITH CONST 'UCTION PERT F ' ANTI)
STATUTE OR RULE. INFORMATION IS COMPLETED BY CH ON F.LLOVVING ITEMS:
ELEVATION WORKSHEET ELEVATION OF BENCHMARK OR REFERENCE POINT:
EXISTING GROUND TOP OF AGGREGATE
[ +1 SHOT H.I. H.I. H.I.
H.I. [ -) SHOT [ -] SHOT [ -] SHOT
ELEVATION
0
AS BUILT INSTALLATION SKETCH
iii r
date.
date of approval
lot grading are in substantia;