602 NE 96 St (2)Owner's Address
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date //-91- OD Job Address 60 o tue 94a ST. Tax Folio 1/ 39 ex. - op) ", j916'<
Legal Description Historically Designated: Yes No
A
Owner/Lessee / Tenant Voi eaSTrasioAA col tiatits5S Master Permit #
S municipal #
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): UILDIN PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Roof roe Amts,.. ).4.9 .7Aesrib.44
Square Ft. Estimated Cost (value) 0.74 40
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.)
Application is herebymade to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are ired for ELECTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNERS 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. Furthermore, I authorize the above- named contractor to do the work stated.
Signature of owner and/or C
ONIM
Wirt Pa%
C6R n 7t/
Notary as to President
My Commissk *of Isle
Date
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FEES: PERMIT RADON C.C.F.
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Competency it Ins. Co.
NOTARY
Building Electrical
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Si Contractor or Owner - Builder
Notary as to Contractor or A4 A,1
My Commission Expir
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BOND
TOTAL DUE S___
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Mechanical Plumbing Structural Engineer
JOB ADDRESS
APPLICANT
PHONE #
APPLICATION #
SHEET OF
MISCELLANEOUS
CRIT QU S EET
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DATE 2/v /N6 :
COMMENTS
PERMIT NO.
ADDRESS:
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MIAMI SHORES VILLAGE
BUILDING / ZONING DEPARTMENT •
SECTION BY DATE
ZONING
ELECTRICAL
MECHANICAL
PLUMBING
FIRE
PUBLIC WORKS
STRUCTURAL
BUILDING OFFICIAL
1. Subject to compliance with alt Fedend, Mate,
County.Vittage rc tos Ind regulations. Village asses
no for accuracy oflor results from
s .
2. This copy of plans meat bs aYdlabte co
building site or no tnspecttca wm be coadcdnd.
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INITIALS
f -•
KNOW ALL MEN BY THESE PRESENTS:
CERTIFICATIONS AND DECLARATIONS
OF RESTRICTIVE COVENANT
WHEREAS, .. •Miami ; Shores Presbyterian Church, .a Florida non- profit corporation (the "Owlet or
"Declarant ") is the owner of the following described property (the "Property") situated and being in Miami
Village, Florida:
Lots 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10, Block 61 and the 15 -foot alley
Running east and west through said Block 61, Miami Shores, Section 2,
According to the Plat thereof, recorded in Plat Book 10 at page 37 of the
Public Records of Miami -Dade County, Florida, and
WHEREAS, the Owner, together with Omnipoint Holdings, Inc. a Delaware corporation (hereinafter
"Applicant ") with the consent of the Owner, has applied to Miami Shores Village, a Florida municipal
corporation ( "the Village ") for a wireless personal telecommunications services antenna permit, pursuant to
Chapter 22 of the Miami Shores Village Code, and otherwise; and
WHEREAS, the Owner and Applicant desire to provide certain assurances and certifications to the Village;
NOW, THEREFORE, the Owner and Applicant each jointly declare and certify as follows:
1. Title. Owner and Applicant have provided evidence as to the status of title to the Property to the
Village.
2. Continuous Compliance. The Owner and Applicant hereby covenant and certify that the wireless
personal telecommunications services antenna proposed for the Property will be made continually
compliant with all present and future promulgated by governmental authorities having jurisdiction
over the Applicant and the operations of the antenna facility, or similar safety standards for other
wireless communications media transmissions. The Owner and Applicant hereby acknowledge the
right of the Village to require immediate removal of any wireless personal telecommunications
services antenna upon the Property which does not meet such safety rules and regulations.
3. Non- Interference. The Owner and Applicant also covenant and certify that any wireless personal
telecommunications services antennas proposed for the Property will not interfere with public safety
communications, and further, will not unreasonably interfere with the reception or transmission of
television, radio, microwave, telephone, digital or similar communications signals or receipt of
signals of nearby residential or business residents. The Owner and Applicant acknowledge the right
of the Village to require, if necessary, frequency relocation agreements.
4. Multiple Accommodations. The Owner and Applicant covenant and certify that the design,
structure or installation of the wireless personal telecommunications services antenna facility
proposed for the Property will be such as to accommodate at least two wireless personal
telecommunications services antenna facilities of other providers, on a non- discriminatory basis, after
applicant's installation, in the manner depicted on Exhibit "A" which is attached hereto and made a
part hereof, to avoid duplication of the erection of wireless personal telecommunications services
antenna towers throughout the Village. Applicant and Owner undertake no obligations hereby to
assure utilization of the structure by other service providers and Applicant and Owner expressly
disclaim any right of power to control or dictate any other service providers' choice or design of
proposed facilities for this structure. The Applicant will not oppose and Owner covenants and
certifies that it will permit co -use of the wireless personal telecommunications services antenna
structure upon the Property by at least two wireless personal telecommunications services providers,
in addition to Applicant, on a non - discriminatory basis. Owner and Applicant acknowledge and
agree that unreasonable refusal to permit co -use shall constitute a violation of Section 22-42 of Miami
Shores Village Code and may result in the Village revoking any wireless personal
telecommunications services antenna tower approval and seeking a mandatory injunction to compel
removal of any wireless personal telecommunications services antenna, in addition to all other
remedies available to the Village for violations of its code of ordinances, and any other remedy
available under the law.
5. Attorney's Fees. The Owner and Applicant hereby covenant and certify that the prevailing party
shall be entitled to recover its reasonable costs and attorney's fees in the event any litigation is
brought to enforce the provisions of this Declaration and Certification.
6. Binding on Successors. The Owner and Applicant covenant and certify that this Declaration and
Certification shall be binding upon the Owner, the Applicant, and each and all of their respective
successors and assigns and that they shall faithfully observe and perform hereunder, for so long as
Applicant operated its antenna facility on the Property.
IT WITNESS WHEREOF, the undersigned have caused this instrument to be executed and delivered
on this Z Le day of J q Yt e, ryt , 2001.
WITNESSES: ( --- 7
OWNER
MIAMI SHORES PRESBYTERIAN CHURCH
BY: c%>!v
WiT) as BUSINESS MANAGER
IMIVIMINUIE—
e. ,rr,, . "i CI K TEST)
Clerk of Session
STATE OF FLORIDA
COUNTY OF MIAMI-DADE)
My commission expires:
STATE OF FLORIDA
September 5, 2004
My , ,s P IHRUigoYFABNINIURANC6, RNG
commission expires:
APPROVED:
)
The foregoing instrument was sworn to and subscribed before nee this day of January 2001 by
N ; \ N o me a- as Business Manager and C /%?a Pkof, as Clerk of
Session of Miami Shores Presbyterian Church, on behalf of the corporation for the purposes therein expressed:
\They are .per o on n ally known to me have produced and
as identification and did take an oath.
DEBRA J. McCLUNE
MY COMMISSION # CC 830214
469. EXPIRES: Apr 28, 2003
141004-NOTARY Fla Mater/ Y S6N Oe & Bonding Co.
)
)
COUNTY OF MIAMI-DADE)
Teresa Blackwell
MYCOMISSION 9 CC466760 EXPIRES
ss
ss
for Miami Shores Village this day of
BY:
BUILDING OI:1
NOTARY PUBLIC
APPLICANT:
OMNIPOINT HOLDINGS
A on nn
BY: e � hStn�t/J cAr
As ' —
'To.4fN1C.jt_ I'iREc-="oK
e foregoing instrument was sworn to and subscribed before me this, day of Januuary 2001
by 1 it,t' / of v .,e( as Developer of OMNIPOINT HOLDINGS, a Delaware Corporation, on behalf
of the corporation for the purposes therein expressed. They are personally known to me or have
produced and as identification and did
take an oath.
VILLIAGE ATTORNEY
, 2001.