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DRIVEWAYPERMIT APPLICATION FOR MIAMI SHORES VILLAGE; Date Job Address 1( G / e,, ( Tax Folio Legal Description 24 7 6S ¢ ol .5 /0 ` Historically Designated: Yes No Owner/Lessee / Tenant /�� % //�� / Owners Address Me Contracting Co. i� C®/'� -/4. ��`�j ��'�� Qualifier A0e4e 7 :7 7 ) State # Municipal # Square Ft. > Mechanical L�N No : as to Owner and/4 Condo President Date My Commission Expires: Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL WORK DESCRIPTION .e�/ �� ° 7 Master Permit # y Phone_ 5 __ Address 3 /f1 /��� — �`�,��� , ale( 395" 01 Competenc #a,.. /sss Co. Estimated Cost (value) 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 work 6'/ otary as to Contractor or Owner -B y Commission Expires FEES: PERMIT , SP RADON C.C.F. NOTARY , APPROVED: 1t — eerlcr■vlq Dw C OVevla ! ytt S Irv'ci Al le / 10�uidi L Zoning uilding a °" 11 jov Electrical ROOFING PAVING FENCE SIGN TOTAL DUE,. 5TY GLADYS J `JIL1AR NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CCIl410 MY COMMISSION EX .'SAL 12-00 BOND 3 LJ0 Plumbing Structural Engineer 7//harni Shorei ?Atqe COVENANT OF OF CONSTRUCTION WITHIN RIGHT OF WAY WHEREAS, ( o w n �, referred to as the Owner of the (own following described property: Legal description /folio #: Lot % t - Block ./// Subdivision Tax Folio #: requests permission to install: Asphalt, concrete [ ] Landscaping [) Other within the public road right of way of SIGNED, SEALED AND DELIVERED in the presence of: 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 -2207 Fax: (305) 756 -8972 9g� (address) IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows: 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 a lien 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 (owner) PERMIT NO. ADDRESS: MIAMI SHORES BUILDING / ZON VILLAGE NG DEPARTMENT' SECTION BY DATE ZONING - ,. ELECTRICAL MECHANICAL PLUMBING FIRE ' PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL 1. Sect to outptlanc..with alt Eedeat. State. County. Wage rotas and regulations. YfItaga assumes no responslbtllty for accuracy oflcc resutts tram these Frans Z. Thls copy of plans must bs avaltabfa on tw8ding cite or no Inspection relit ba cottdcttnd. 1.et0 \ ru r l'l1C 5t1tt JOB ADDRESS APPLICANT PHONE ft APPUCATION f SHEET OF MISCELLANEOUS R. kVE � -(4) 6114 PfhJ( _S — 5 ki GATE 2--e/4/V6 COMMENTS W ...2,9/60 .6) 5E 0 s mac/ stile - d7 /jest - 5'e ) ,eck / ' x.dy4 Q oil , r%,d rd6 /14 r7 t ,AJ (d /-'1 ! CY /.' i Y 6'4'4 . 4 1 y , z 44 LS s o ? D ' �/'/ *WI ce fro 4 /vie, O i're .r- drive. D7 /o //o% hi-et ohm en 3/0°9 01 Q' / C/P. e4/41 / 0( 04-4' $ /-g 14%f al( (5 L7 ? /.(24 /S diem eN 5/44 / 0 1, 40 4O 7 m4.4 ® dl d /sae «4 /e#t� r / e1 — e 5e_ rc CJ -S oft 3'a 04 c? ve r°a /f Got, o - t e_ b6 r cl r d' cove cdto.{(cl t9 INITIALS 11 ..� - v • + .� �• ar.• �i v• LMW ImL _3/ 1 G�J41 9 ASPHALT BOUNDARY SURVfY SCAM: - 3C e; e z kiv r t s .=) e/ • PROPERTY ADDRESS: C50 qF 9IZ S : . , X► lA Wiarni. 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