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PLUMBINGSTATE OF FLORIDA PERMIT # q..5/ DEPARTMENT OF HEAL'T'H AND REHABILITATIVE SERVICES DATE PAID ONSITE SEWAGE DISPOSAL SYSTEM FEE PAID ,$ CONSTRUCTION PERMIT RECEIPT # Authority: Chapter 381, FS & Chapter 10D -6, FAC CONSTRUCTION PERMIT FOR: [IJ] New System [0 ] Existing System (IJ) Holding Tank (hi) Temporary /Experimenta [ 1() Repair [ 0) Abandonment ( 0) Other(Specify) APPLICANT: APPROVED BY: ; F 4 PROPERTY STREET ADDRESS: 114 , , ..� LOT: 0 BLOCK: ,1 SUBDIVISION: t )/ 4 N/#4 PROPERTY ID #: /`� /`� ( SECTION /TOWNSHIP /RANGE /PARCEL NUMBER) (OR TAX ID NUMBER) a =o=a= ==ss =___ == s=as===s=== SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D 4, FAC REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS..FROM:THE.RATE OF ISSUE. ALL OTHER PRRMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SAT1SFARY PERFORMANCE FOR ANY SPECIFIC PER:IQD,QE..TIME. ANY ,CHANGE IN MATERIAL FACTS WHICH SERVED AS ,A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERM T APPLICATIO(t. SUCH MODIFICATIONS MAY RESULT LN THIS PERNIT MADE NULL D VOID. SYSTEM DESIGN AND SPECIFICATIONS T [ N&- ] [GALLONS / GPD) SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IA SLta2:[ A ( --- ) [GALLOWS / GPI)] CAPACITY MULTI - CHAMBERED / IN SERIES e ( ) N [ -- ) GALLONS GREASE INTERCEPTOR CAPACITY (MAXIMUM CAPACITY SINGLE TANK: 1280 ± `t3ALL*us) K [ _ ) GALLONS PER DOSE. DOSING TANK CAPACITY DOSE RATE 1 ) PER 14 HRS NOf OF PUMPS: ( 1 ,1 / r D [ - .3-0,12 . 1 SQUARE FEET PRIMARY DRAINFIELD SYSTEM - 4 "'"fey U 4 sle _~s 1 Pfe. °Yt."' R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ `.1 STANDARD ( FILLED ( ) MOUND [ ) I CONFIGURATION: [ ) TRENCH ( - BED ( ) N T F LOCATION OF BENCHMARK: / 0 ' 3 3 , / .:5 • r'yi' 4 7 /dIr &I,ii+ ((fin 4.661 67/".) I ELEVATION OF PROPOSED SYSTEM SITE (7,11) t44:10C 4 T) (ABOVE r BENCHMARK E BOTTOM OF DRAINFIELD TO BE [ (03. i G ) irEMEM T) fABOV n R? BENCHMARK L D FILL REQUIRED: (/Jp4) INCHES DATE ISSUED: 4/A / AGENT:, A.)4 ,(4' 1 ) 4 J e vo EXCAVATION REQUIRED: ( 30 ) INCHES o I' 3 '(/ 12 h L o &,,Ty L'aorse :;440c4 vN ,IGr ioh4 o f f r*a 4; fd T H -r u P r f G / ' v. 4,00f l d R 6(1 44- 01 a 1 }rr/ f (rj 1. so SPECIFICATIONS BY: TITLE: TITLE: Mk Sir i(, MIA ;MALL At NUINl+EU AND A 8KLIO DEFLECTION DEVICE INSTALLED ON 11ij OITUT TI HRS-H Form 4016, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744-001-4016-0) L'N woe- EXPIRATION DATE: as1= xs =a== CPHU Page 1 of 2 INSTRUCTIONS: PEaI XT NUMBER: Permit tracking number. assigned by CPI -I.J. APPZ. °_CAT ION 011: Check type of permit, if 'Other" specify type in blank. APPLICANT: Property owner's full name. TELEPHONE: Telephone number for applicant or agent. AGENT: Property owner's legally authorized representative. MAILING ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION or PROPERTY IIDl /: 27 character id number for property. (CPHU may require property €pprais :.' f1 e_ sectio^Jtowr_rhipkenge /parcel nurzbc•) SYSTEM DESIGN AND SPECIFICATIONS: TANK: Minimum specifications from Chapter 10D-6, FAC. DRAINFIELD: Minimum specifications from Chapter 10D-6, FAC. OTHER: Other specifications, such as operating permit requirements, low - volume flush toilets, variance provisos. SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be scaled. APPROVED BY: County Public Health Unit (CPHU) personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by CPHU. EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the date issued. STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTI91 PERMIT Permit Application Number ` T °I. 1/0) PART II - SITE PLAN Scale: Each block represents 5 feet and 1 inch = 50 feet. PI , i . _ i I UU •U' •UIU __ • U S B � - �_�!— � - - -- —� �- � � ���- = = �� - - �=■ a -:•■■■ ■■■ �, I III II i 111 1.1. u .0 i i= � ■ ■...i...a. ■ii ■ � ■ •■ ■�.■■ ■ ■ ■ ■■ ■ ■ ■■ = I_ :M:. ■U U I .M .■l .s .EM ■�■.■■EE... ■.■ M IN mOl: i ■ . .U; ' 11 i 3iU � °: U� f UM EMMAMME .. • ::;; ■ ■ ■. ..: III ■ ■� II 1 ■ ■ � . � M.■ ■ ■ ■i ■■ ■ ■ ■ ■ ■ ■ ■■ li IliiiiIIIIdd I =. =1..1:11 .■■..• ■ ••M.■ w . ■ ■VU 1. =.11.61 .. .� TOWMPOIR / ■ M■ • ■ ■ ■ ■■■■ s:.■ _� ■ ■w . ti did • III— ■ h _ i �i �■■ u 1 1 ■ i :1 ��.�� ■i _ ■ ■■ ' i ■ ■■ ■ ■�.... • ■! 1 I f/ mom ■ ■ I ■l ■l ■ ■ ■■�E■ i s mi In Iii IMI ■i� u 1� ■■ ■■■■■■ UM UM MA !! I � .. � I • •OuW■ ■ ■■■■ ■ ■■■■■■ 1 INEMSIEN ..� �■ ■ ■ 1 ■■■■■■■■■■■■ ■ ■ ■ a ,uuumlI1� I 1 ■■ ■■■■■■■le ■■I ■ ■ ■■■■■ ■bntl ■ ■■� ■■'i �_ �i ■ ■■! ■■!■■■■■ ■ ■■ ■■ ■ 1 i ►� �■ ■ ■ ■■ ■ ■■■■■ II •■ ■■ •• 1i ■■�■� ���� ■ ) ,� _ ■ ■� �■• .•.�� �_ ■ ■ c ■■ i =I ��=i� iii' M :III ' 11 ■II�i�■irI■■ ■E ■ ■ a v 1111101 i ■'■■US ■■■■ ■ ■■■■■■ ■■ ■ ■ 11111111111011111111 . ■ ►� ■■i■■ � � n ■■■■ ■TI■■■■■■ ■■M • ■ (s■�� i■ ■w■■■ ■ r, ■■M■■■■■■■■■nm■■ ISON MN in M MO MO I■■L - ■■ 1.110 n U •I ► M O■■•■■U • E ll ■■■■ ■■■■ ■ ■.I■i■ ■■ •• ■ ■ ■ ■■ ■M ■■r.■O■■ ■■■■ ►� ■■1 MMI■M ■■ I ■ ■EM■■■■ ■ ■Era s■■ ■■■■■ 1E =lli•il■ mml• i (■ ■ M ■1. ■1.I ►■L=:(.■ �■MMOMEE•Jiiu11 ■� =. ■.�EMEMME �ii ■M ■ ■E. ■MC ■■■Mi ■O ■M ■ ■■ ■ ■■■■■ ■ ■ ■ ■M■ ■■ ■V■■■ ■a ■i.i■■■ ■i■■■M■ ■11I ■!1 ■ ■ ■■■i' ■ ■ ■■M■ ■■■■ii■S■!VAi ■ ■M■■■ ■■■■■■■■C� ■ M ■■■■ ■MEMMM■ME■■OM■i ■ 1 ■E MM MA ■ ■ MA■■ ■M ■ ■1A■■■M ■MMASr.■■■ ■ ■■■■ MEMO■ ■M ■' ■ ■E■ ■MM■■ ■M■■ ■ ■E ORSIOMM■ M ■ MM ■Miiirll'+0mmi sONO ■MOM■ ■ ■ ■ ■ ■ ■ ■=M■Ei■ ■■■■■M■■ ■■■■�i■I1 ■r® 511L M■r1 ■ ■MO ■Mi ■■� AIWOM■■■ ,A, MMMMM ■ ■O ■/ ■ ■ ■ ■ ■ ■ ■ ■ ....w•..�1..1w w.wm ■ ■ulwi ■■ ln�tamoma•li� mil ... -.•� iii Y■■ ■ ■ ■ ■ ■■ ■■ ■ ■ ■ ■ ■ ■!U ■ ■ ■ ■ ■ ■ % ■■■■ •■ROMMOO u\■■M54:.%■■■■■■E OMM EMOM■_ ■ ■■■ ■■ ■■■■i ■■ ■ ■ ■ ■ ■■■ ■ ■■ IIMMOMMMOOMMOMMUMMEMOOMMMEMMEMMEMBIMMENIMMOMEMOMMONIMOMMOOMMEMOMEMMOMOMMMOMMEM Notes: FOSTER: 1245 NE 98 STREET, 33138 OLD SYSTEM OVERFLOWING Site Plan suOmittpd by: Plan Approved By r 1 �, �.: H (1. ›/.3e-c. I. LL @W'MJGES MUST BE APPROVED BY SIG' • IRE Not ( Approved HRS -H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744-002-4015-6) TI t e. County Public Untt_2: HEALTH UNIT Page 2 of 3 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 4/4/95 Job Address 1245 NE 98 STREET, 33138 Tax Folio Legal Description Owner / Lessee / Tenant KIM FOSTER Master Permit # 37 Owner's Address 1245 NE 98 STREET, MIAMI SHORES 33138 Contracting Co. NORTH DADE SEPTIC TANK Address 800 NW 111 STREET Qualifier DENNIS NEVILLE SS# State # 025836 -8 Municipal # Competency # 12842 Ins.co. TRAVELERS /ESIF Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION INSTALL LAUNDRY WASTE INTERCEPTOR WITH 150 SQ FT DRAINFIELD Square Ft. 150 Estimated Cost(value) $ SJ© 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 hereby made 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 required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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 c uction and zoning. Furthermore, I author x a the above -named contractor to do the work state JrN444 Signature of owner and /or ondo President Da N My ** * APPROVED: Zoning OA II to Owner( sion Exp PUBLIC; STATE OF T•LCT:!DA AT 1Y COMM1SiON rX7.S.ES ,:i.V;' 3:c 1T,'5 W atiOiD tint 11:1c:i1:13'.=*i:Y a, Att;G:.,, -. Condo President phone 754 -3375 ec) otary Co ntrac or .r Owner- Builder as to Con r. cto or. Owner -Builder ission E es: NOT PUBLIC: 517:117 er FL 11'51 ± A MY COA1.1:5 i t�W ** 7.1Y ;aTBS p * ocJ FEES: PERMIT 3a RADON C.C.F. I NOTARY TOTAL DUE 3/ Fire Other Buildin �liectrical Mechanical Plumbin_ �) ����/ Engineering 0 T H E R PROPERTY STREET ADDRESS: /,2 y6 N . y f' LOT: PROPERTY ID #: SYSTEM DESIGN AND SPECIFICATIONS D [ I 1 SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ ) SQUARE FEET SYSTEM A TYPE SYSTEM: [ ) STANDARD ( ) FILLED I CONFIGURATION: [ ) TRENCH [ j BED N F LOCATION OF BENCHMARK: SPECIFICATIONS BY: APPROVED BY: 1 DATE ISSUED: / l r/�1 y � 1 Q -- STATE OF FLORIDA `l 433¢ PERMIT # 2 DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES DATE PAID ONSITE SEWAGE DISPOSAL SYSTEM PAID $ CONSTRUCTION PERMIT ' RECEIPT # Authority: Chapter 381, FS & Chapter 10D - FAC CONSTRUCTION PERMIT FOR: [--7 New System *--') Existing System "(""") Holding Tank Temporary /Experimental [ V ] Repair (""..] Abandonment [ J Other(Specify) APPLICANT: AGENT: „ / Q__ _ BLOCK: SUBDIVISION: SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 100 -6, FAC REPR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPR=E ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. 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. T [ DI)] GALLONS GPD) SEPTIC TANK EROBIC UNIT CAPACITY TI-- CHAMBE :ED /IN SERIES:( j A [ ] (GAL ONS / GPD) -- CAPACITY ERED/IN SERIES:[ ] N [ ) GALLONS GREASE INTERCEPTOR CAPACITY (MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS) K [ ) GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE L j PER 24 HRS NO. OF PUMPS: ( J I ELEVATION OF PROPOSED SYSTEM SITE ( ) (INCHES /FT) (ABOVE /BELOW) BENCHMARK /REFERENCE POINT '°E BOTTOM OF DRAINFIELD TO BE [ j [INCHES /FT) ( ABOVE /BELOW4 BENGOMAR REFERENCE POINT L D FILL REQUIRED: ( ) INCHES EXCAVATION REQUIRED: [ J INCHES ( SECTION /TOWNSHIP /RANGE /PARCEL NUMBER) [OR TAX ID NUMBER) s TITLE: TITLE: t HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be us ` (Stock Number: 5744-001- 4016-0) i -4424.4 ` -3' -°« ' INSTALLER /CONTRMTOR == = =aa sssss s s = = == === ass [ j MOUND [ ) [ ) 14 4.4g- CPHU EXPIRATION DATE: // , 5 76 Page 1 Of " WORK DESCRIPTION FEES: PERMIT PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date / Kob Address Legal Description / Owner/Lessee / Tenant �J /� r €-5( "� 'eL2 I m e mil Owner's Address / 2 - 1 !)VC // )}-)) /LA Q 2 t(/ 9O Tax Folio Contracting Co. Qualifier State # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICA t°n Municipal # Si l� of owner an or Condo P esident APPROVED: Zoning Building Mechanical Historically Designated: Yes No Competency # Address Address Master Permit # Ins. Co. Phone ? S © / Address / / 4 S CLj SS# Square Ft. Estimated Cost (value) Notary as to Owner and/or Condo President Date My Commission Expires: RADON C.C.F. ECHANICAL ROOFING PAVING FENC SIGN e . . (ce 7 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 hereby made 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 required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the w stated. 1.1 l■■ • `� // " / ` Signature of Contractor or Owner -Boil � er Date /7/? Notary as to Contractor or Owner -Bur der My Commission Expires: (, COF >SP "f � C7i r 31 h r _ l < c MY CCU „_,!C•N f; NOTARY, BOND TOTAL DUE Date La a ias as . •Set and ilea*/ Wit Wormed &nowt of Pe The uedt rsegned Trx Wid the rimida plied with the pro tcras . p erre d eadh this �s d by the lied by Miami L dip maters