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PLUMBINGBUILDING ❑ ELECTRICAL ❑ PERMIT o PLUMBING N . 8 914 ROOFING Owner of Building_ Architect Contracto or Builder Legal Descriptic Address Building MIAMI SHORES VILLAGE. FLORIDA DATE Work to be performed under this Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or,n the statements specifications an at he asstLmes responsibility for work done by his agents, servants or employees. / (. 2 4 Contractor's 7 License No 1954_ Signed • ,e INSPECTOR V In consideration of the issuance to me of this permit I agree to perform the work covered he nder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications su itted to the proper authorities of Miami Shores Village. In accepting this pe it I assume res nsibilijgt„�11 work done by either, myself, my agent, s or employee. CONTRACTOR OR BUIL BY ■ , • *.._ ' '-,.., 4 r; c_ .r ;4, J. r 5 iC 1 fi ` J.. . - ►,, 1 —, i .. C f \ ie' A. � n Lot Bl. Subdi- vision f r t i ' f c:, ,� .• S Ft Amt, of Permit / - $ �'' Value of Project $ BUILDING ❑ ELECTRICAL ❑ PERMIT o PLUMBING N . 8 914 ROOFING Owner of Building_ Architect Contracto or Builder Legal Descriptic Address Building MIAMI SHORES VILLAGE. FLORIDA DATE Work to be performed under this Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or,n the statements specifications an at he asstLmes responsibility for work done by his agents, servants or employees. / (. 2 4 Contractor's 7 License No 1954_ Signed • ,e INSPECTOR V In consideration of the issuance to me of this permit I agree to perform the work covered he nder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications su itted to the proper authorities of Miami Shores Village. In accepting this pe it I assume res nsibilijgt„�11 work done by either, myself, my agent, s or employee. CONTRACTOR OR BUIL BY BUILDING ELECTRICAL ❑ PLUMBING ROOFING a Owner of Building Architect Contractor or Builder Legal Description, Address of Building Lot MIAMI SHORES VILLAGE. FLORIDA ❑ DATE A PERMIT N? 8880 . 7 r Work to be performed under this Permit s +/ f • ✓t 3 .. W -77 Bl. This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements +specifications and that he assumes responsibility for work done by his agents, servants or employees. ' iitoof ,.. Signed:, !• e. BY 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 per 't I assutye responsibility for all work done by either, mysglf, my ag servant or employee. 1 r`y� Subdi- . r vision Sq. Ft Value of Project $ BY 195 % Contractor's License No Amt. of Permit $ AUTHORITY 7 -ft T Permit No. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of wo Owner's Name and Address ._r -_� � - -_ No.- ------ .-- .... ____________ Street__ Registered Architect and /or veer_ - -- __ - -- Employing Plumber's Nam __ _ !_ e_-_ _-SC -_ _l_ .-e-e___ —__ _ __ —____— Street___....._ Stivet and Number where work is to be performed—No __ B _ — 1 Location and Legal Description Lot____ _______ ._ oc.. I Subdivision " - 6 treet- __..._-- State work to be performed and purpose of building (By Floors) New Building _- _----- ----- -- - -- -_ -- Remodeling MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEN% APPLICATION FOR PLUMBING g a�IIIT Date v - AddlUon__Repairs No. of Stories Size Septic Tank s ^ � -- Type of Tank_ _ Capacity Gals Feet of Drain Tile _ `' �st(Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Amount of Permit $ _.Size of Soakage Pit (Signed)_ Plum . ing Inspect • r. The undersigned applicant for this building permit does hereby certify that he understands and accepts his .ligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida P Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contracto employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as ar required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES NKS SINKS SLOP SINKS LAUNDRY Tuff U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•N6 TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL Corms. LIST CHECK -ft T Permit No. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of wo Owner's Name and Address ._r -_� � - -_ No.- ------ .-- .... ____________ Street__ Registered Architect and /or veer_ - -- __ - -- Employing Plumber's Nam __ _ !_ e_-_ _-SC -_ _l_ .-e-e___ —__ _ __ —____— Street___....._ Stivet and Number where work is to be performed—No __ B _ — 1 Location and Legal Description Lot____ _______ ._ oc.. I Subdivision " - 6 treet- __..._-- State work to be performed and purpose of building (By Floors) New Building _- _----- ----- -- - -- -_ -- Remodeling MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEN% APPLICATION FOR PLUMBING g a�IIIT Date v - AddlUon__Repairs No. of Stories Size Septic Tank s ^ � -- Type of Tank_ _ Capacity Gals Feet of Drain Tile _ `' �st(Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Amount of Permit $ _.Size of Soakage Pit (Signed)_ Plum . ing Inspect • r. The undersigned applicant for this building permit does hereby certify that he understands and accepts his .ligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida P Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contracto employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as ar required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Permit No v ! Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of w . 7 s Owner's Name and Address_.. Registered Architect and /or nginee Employing Plumber's Name Location and Legal Description Lot__ Block Subdivision ._._._,__. Street and Number where work is to be performed —No =4+ State work to be performed and purpose of building (By Floors)_ New Building Remodeling_ ___ Addition________ Repairs No. of Stories. Size Septic Tank ...... ___ - -.7 Feet of Drain Nature of Water Supply: City — Well. -- -- -_ - My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING .°";e'>,MIT T Amount of Permit $ -� - --- -- — - — - - - - -- (Signed) - --- --a (Signed)__ Street__ ank_- --_ Capacity Gals ee •f Tank or Drain Field from Well Size of Soakage Pit lumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this perinit, as are licensed by Miami Shores Village. STATE OF FLORIDA, 1 COUNTY OF DADE. Befare me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the__ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by hin, stated are true. Notary Public, State of Florida Master P1 NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSR6 BATH TUBS SHOWERS LAVA Toms SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK Permit No v ! Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of w . 7 s Owner's Name and Address_.. Registered Architect and /or nginee Employing Plumber's Name Location and Legal Description Lot__ Block Subdivision ._._._,__. Street and Number where work is to be performed —No =4+ State work to be performed and purpose of building (By Floors)_ New Building Remodeling_ ___ Addition________ Repairs No. of Stories. Size Septic Tank ...... ___ - -.7 Feet of Drain Nature of Water Supply: City — Well. -- -- -_ - My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING .°";e'>,MIT T Amount of Permit $ -� - --- -- — - — - - - - -- (Signed) - --- --a (Signed)__ Street__ ank_- --_ Capacity Gals ee •f Tank or Drain Field from Well Size of Soakage Pit lumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this perinit, as are licensed by Miami Shores Village. STATE OF FLORIDA, 1 COUNTY OF DADE. Befare me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the__ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by hin, stated are true. Notary Public, State of Florida Master P1 NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Pennit No ...... 1.2 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address J.S. Carroll Registered Architect and /or Engineer_____ BrookB Sprinkler Co. $ _80_ _5_st_ Employing Plumber's Name No.. Street. ___ .__. —__ Location and Legal Description Lot. Block Subdivision.____ .._.._ Street and Number where work b to be performed —No �_2_ NE__Q8th. at• Street. State work to be performed and purpose of building (By F1oors)_____2n w.11 k..8prfnk1er..By8.tata New Building _ ._ ___ Remodeling Addition...___ _..____..._ Repairs No. of Stories _ Size Septic Tank ...... __ -- Feet of Drain Tile_____ Nature of Water Supply: City—Well- Amount of Permit $___ 8 00 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING ^t;t,,.MIT Type of Tank No._9 NE 98th St. str Capacity Gals. Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit ( Signed) _ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accep is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Flo • a Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed). Date 91.151.52 Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. I Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. M Coupon Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUp e SH OWLII• LAVA. TORIES SINKS SLOP SINK• LAUNDRY Tuns U RINALS CATCH BASIN FLOOR DRAIN DRINK NO FOUNT TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM•0 POOL coNTR. LIST 2n X ` CHICK Pennit No ...... 1.2 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address J.S. Carroll Registered Architect and /or Engineer_____ BrookB Sprinkler Co. $ _80_ _5_st_ Employing Plumber's Name No.. Street. ___ .__. —__ Location and Legal Description Lot. Block Subdivision.____ .._.._ Street and Number where work b to be performed —No �_2_ NE__Q8th. at• Street. State work to be performed and purpose of building (By F1oors)_____2n w.11 k..8prfnk1er..By8.tata New Building _ ._ ___ Remodeling Addition...___ _..____..._ Repairs No. of Stories _ Size Septic Tank ...... __ -- Feet of Drain Tile_____ Nature of Water Supply: City—Well- Amount of Permit $___ 8 00 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING ^t;t,,.MIT Type of Tank No._9 NE 98th St. str Capacity Gals. Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit ( Signed) _ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accep is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Flo • a Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed). Date 91.151.52 Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. I Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. M Coupon Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date/o/ /9/ Job Address Legal Description 4! 0 2. 2 K9 Owner / Lessee / Tenant GL,t0 Id Tb `' le- Owner's Address Contracting Co. Qualifier State # Architect /Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL (PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION Square Ft. 30o Estimated Cost q p©, 0 .p 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 stated. Signature of Owner and /o- Condo President Date: 0WA144.441/ /4/14 Not as/to Owner and /or Condo President My Commission Expires: 4///4?):.-- `-- * * * * * * Fire PERMIT FEE: APPROVED: v071 8 -5 S4. Tax Folio // � 71 /�7de Master Permit # Phone Vigevv1anv)11 /{1% �a L ( ✓Yl v%. rr Phone Co 3 S - X5_ /4 Zoning Mechanical Competency11 Address a l q ,1/ w a, a Cf arc() aa6 O r Ins . Co .rev` V\S'/ I Va.A; Q , verCai- Address Address Address i nature of Con rector or Signature Owner-Builder Date: /o - /5" 9 Notary as to Contractor or Owner - Builder My Commission expires* NOTPRY ,ZU;;LIC ST4TE OF f=LOWDA. MY C07 "U SSION EX JULY 31,1'9961 Other M ED THRU GENERAL INS. UN4 Electrical )I)Eng1neering _ _ f DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APP CATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Date of Application/ 0— c^ Type of Establishment 300 34uare Feet .:.ela Type of No. Bedrooms Residential (each dwelling unit) Single Family Residence 3 Bedrooms AUDIT CONTROL NO N 240411 c./ -i 7L) HRS-H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744.001- 4015-1) Au) : Chapter 381, FS Chapter 10D -6, FAC PART I - APPLICATION- Applicant's Signature Permit Application Number Name of Owner Mr. Howard C.• Doyle Telephone Number (305) 757 -0747 Mailing Address of Owner 95 N.E. 98 Street, Miami Shores, Florida 33150 Owner's Agent Ringel;mann .Plumbing Builder Agent's Mailing Address 2190 N.W. 22nd Court Telephone No (305) 635 -4516 Property Street Address 95 N.E. 98 Street, Miami Shores, Florida 33150 Lot No Block No Subdivision Date Subdivided NOTE: IF NOT IN A SUBDIVISION ATTACH A METES AND BOUNDS DESCRIPTION This Application is for: New System Repair Yes Existing System TOTAL FLOW = Sewage Flow Sewage Flow (Gallons per day) Based On Heated or Cooled Area (each dwelling unit) ft ft Exact Directions to Property ALL CHANGES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT HRS-H Form 4015. Feb 85 (Obsoletes previous editions which may not be used) No. Dwelling Sewage Flow Units (Gallons per day) Page 1 of 3