1160 NE 102 St (4)(2/. ssn
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hereby apply for a certificate to re -occupy the single family residence known as: (address)
/ • - - ' I' _ , Miami Shores, Florida.
Legal description
Lot: 6
Applicant
APPLICATION FOR CERlr'ICATE OF RE-OCCUPANCY
Print Name( Jp35 4fM , es,,, 0
,Btocic / 7 6 ,PB&PG:
I hereby certify that I understand that the zoning of the ,property is for ' e-
and that it is unlawful for more than one �Y to reside therein. I also understand that any use
Certificate of Re -Occupancy that may be issued by Miami Shores Village, Florida, certifies only
that the referenced property is being used for single -family purposes and that such Certificate does
not constitute any representation, warranty or certification as to the condition of the dwelling
other structures on such property. or
Daze:
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For the purposes of conducting the inspection required by
Development and Zoning Code, contact: Sermon 902 of the Nliarai Shores
Contact Name: a:� a 1 /� (' • 26,o C
Telepho
Buyer: Seller. Realtor Company Name:
Inspection: B '
i . Droved: V Denied: Dare:
.8X -'7
S-- s/ 76
CERTIFICATE OF RE- OCCUPANCY
On behalf of vami Shores Village, Florida, the undersigned certifies that the property described
in the application has been inspected for the purposes of re- occupancy pursuant to Sections 901
and 902 of the Miami Shores Land Development and Zoning Code and that such property may be
re- occupied by the applicant for single- fa*nily residential purposes.
MIAMI SHORES VILLAGE, FLO
By.
Date of Certification:
THIS CERTLh1CATE VERIFIES THAT nit REFERENCED PROPERTY
HAS BEEN INSPECTED BY MIAMI SHORES VILLAGE AND HAS BEEN
DETERMINED TO PRESENTLY COMPLY WITH 'i "HE SCHEDULE OF
REGULATIONS OF 'DIE MIAMI SHORES LAND AND DEVELOPMENT
CODE PERTAINING SOLELY TO a REQUIREMENT THAT EACH
ONE -FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR
A ONE-FAMILY DWELLING PURPOSE ONLY; HOWEVER, THIS
CERTIFICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR
WARRANTY AS TO rui CONDITION OF THE DWELLING OR OTHER
STRUCTURES ON TI H PREMISES DESCRIBED HEREIN, OR ANY
ASPECT OF SUCH CONDITION, AND INTERESTED PARTIES ARE
ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION
OF THE PREMISES IN ORDER T0. DETERMINE 1 HE CONDITION
THEREOF. •
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