955 NE 98 St (11)BOB'
Date:
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1 SEPTIC & DRAIN INC
. Septic Tanks • Grease Traps
• & brain Fields • Sewer
Jet Cleaning
CCN000652 • State Certified • Septic Tank Contractor
P.O. Box 612333 • North Miami. Florida 33261 -2333
Phone: (305) 558 -5818
FACSIMILE TRANSMISSION
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Please deliver these documents immediately to
To: H"P 11
Of h re s
Fax #
From:
Dade (305) 558 -5818 * Brow (954) 920 -5099 *
Fax (305) 893 -0270
# Of Pages Including Cover Sheet
MESSAGE: OtSS
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"24 Hour Service • Licensed & Insured"
4
APPLICANT'
AGENT:
PROPERTY ADDRESS:
CONSTRUCTION: - TAPP
FINAL SYSTEM
DI 4016,
TANK
(01]
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[03]
[04]
[05]
[06]
(07]
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[O9]
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SWAGS TREATMENT AND DIPOBAL SYSTEM
CONSTRUCTION INSPECTION AND 'RNAL APPROVAL
PAT: BLOCK: SUBDIVISION:
. PROPERTY ID #:
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITS STATUTE OR RULE AND MUST 31 CORRECTED •m�si�
mmmmmmAeiii+ .......iio.siir :Gas
INSTALLATION
TANK XISE [1]
TANK MATERIAL
OUTLET DEVICE
MULTI - CHAMBERED 1 Y / N ]
OUTLET FILTER
LEGEND
WATERTIGHT
LEVEL
DEPTH TO LID
FILL / EXCAVATION MATERIAL
(22] PILL AMOUNT
[23] FILL TEXTURE
[24] EXCAVATION DEPTH
[25] AREA REPLACED
(26] REPLACEMENT MATERIAL
EXPLANATION OF VIOLATIONS / REMARKS;
[ 1 �r.i_•
[ 1
[ )
[ 3
VED,DISAFPItoVED] t
ISAPPROVED] :
[
•
DRAINFIELD INSTALLATION
[10) AREA (1] .[ SQFT
[11] DISTRIBUTION 302 _ HEADER
(12) NUMBER OF DRAINLINES
[13] DRAI)u INK SEPARATION
[14] DRAINLINE SLOPE
[13] DEPTH OF COVER
[16] ELEVATION [ABOVE /BREAM] BM
[17] SYSTEM LOCATION
(18) DOSING PUMPS
[19] AGGREGATE SIZE
[20] AGGREGATE EXCESSIVE FINES
[21] AGGREGATE DEPTH
10/97 (Previous Editions May So Used)
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Health Department
PERMIT MO.
DATE PAID:
FEE PAID:
RECEIPT ft
SETBACKS
(27] SURFACE WATER
[20) DITCHES
[29] PR/ VATS WELLS
[30] PUBLIC WILLS
[31 ) IRRIGATION WELLS
( POTABLE WATER LINES
[33] BUILDING FOUNDATION
(34 ] PROPERTY LINES /1.
(33) OTEZR
FILLED / MOUND SYSTEM
[36] DRAINFI=LD COVER
[37] SHOULDERS
( SLOPES
(39] STASILI=ATION
ADDITIONAL INFORMATION
[40]
(41]
[42]
[
[44]
[
1461
[47]
(
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UNOBSTRUCTED AREA
STORMWATEE RUNOFF
ALARMS
MAINTENANCE AGREEMENT
EUILDING AREA
LOCATION CONFORMS WITH SITE PLAN
FINAL SITE GRADING
CONTRACTOR •
OTHER
ABANDONMENT
] (49] TANK PUMPED / /
) ( TANK CRUSE= S FILLED / /
7
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J. J.'
CND DATE:
CUD DAs
Peg. 2 of 3
4
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APPLICATION FOR CERTIFICATE OF RE-OCCUPANCY
1, ,Ing !
to re- occupy the single family residence known as : (address)
SS TV r= 9g
Miami Shores, Florida.
. Legal Description:
Lot:
I hereby certify that I understand that the zoning of the ro e
and that it is unlawful for more than one family to reside therein for I I also u derstand that a use
Certificate of Re= Occupancy that may be issued by Miami Shores Village, certifies any
referenced property is being used for single-family u only that the
constitute any representatio warrant
p � °S� and chat such Certificate does not
4 arranty or certification as to the condition of the dwelling or other
structures on such p operty.
Applicant
Print Name P4-1-11-1c-"-
.
***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
x******* * * * * * * * * ** * * * * * * * * * * * * * * * * * * * **
For purposes of conducting the inspecti' n required by Section 902
Development and Zoning Code, please contact: of the Shores Land
Contact Name: A Telephone:
Q - 75 7 --
Buyer
Application Fee ($50) paid: Cash
Inspected by:
Comments:
BIock
Realtor Company Name
Approved
PB & PG:
Date / / (A
Denied
PAGE 1 OF 2
7 — S - 600
hereby apply for a certificate
Date 1 ( ( l�.
CERTIFICATE OF
R E - OCCUPANCY
On behalf of vfiarai Shores Village
described in the above application has been inspected for purposes r
a, the undersigned certifies that the property
Sections 901 and 90? of the Miami Shores Land Development o� re - occupancy anc pursuant
o and Zoning p n t at to
property may be re- occupied by the above applicant for single-family Code u and that such
�fe- family residential purposes.
PAGE2 OF2
MIAMI SHORES VILL FLORIDA
By:
Date of Certification:
THIS CERTIFICATE VERIFIES THAT THE RE FE
PROPERTY HAS BEEN INSPECTED BY Iv SHORES
VILLAGE AND HAS BEEN DETERMINED ORES
COMPLY WITH THE SCHEDULE OF ED TO PRESENTLY
SHORES LAND AND DEVELOPMENT TIO OF THE
PERTAINING SOLELY TO THE REQUIREMENT CODE E .
ONE-FAMILY DWELLING IS USE �r EACH
USED FOR HONE -F �VT'ENDED TO BE
HOWEVER, AMIZ,Y DWELLING PURPOSE ONLY;
THIS: DOES NOT CONSTITUTE
REPRESENTATION OR WARRANTY AS TO THE C ANY
OF THE DWELLING OR OTHER STRUCTURES
PREMISES DESCRIBED HEREIN, OR ANY ASP C E
T T F
CONDITION, AND INTERESTED PERSONS ARE ADVI SUCH
ENCOURAGED TO MAKE THEIR OWN INSPECTION OF T �
AND
PREMISES IN ORDER TO D OF
PREMISES THEREOF. THE CONDITION,