400 NE 100 St (3)Company J
PHONE
Job
Address or e c c
Time Ready
Date Ready
REQUEST FOR INSPECTION
Inspection /Z e ��'�"
P.M.
I, the undersigned, do hereby swear that the Builder's Bond,
# 7Q% , issued to me on premises at // 410 N. E. 100th Street
(Street Address)
has been 100t.
1 9 _•
3
SIGNED AND SWORN TO BY4FORE M! This
1'
Notary Public
My Connie/don Zzpiress
DAY -OF
1 hereby certify that the construction contemplated under
the above Bortd has boon completed and. t . t the builder thereof has
caused the surrounding premises to be o eared and repaired in as
good condition as they were before c : • n id ccnstrustion.
UILDING & Z0NINt DIRECTO
Miami Shares Village