DS-11-1119Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 161129 Permit Number: DS -6 -11 -1119
Scheduled Inspection Date: January 09, 2012
Inspector: Bruhn, Norman
Owner: BISCHOFF, DOUGLAS
Job Address: 9879 NE 13 Avenue
Miami Shores, FL
Project: <NONE>
Contractor: DECORATIVE MASONRY INC
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132050090490
Phone: (305)757 -7765
Building Department Comments
Replace existing chatahochee courtyard and rear patio with
travertine marble.
AS PER BUILDING OFFICIAL, OK TO EXTEND PERMIT
FOR ONE MORE WEEK. CONTRACTOR HAS BEEN
CONTACTED. DANIEL AULTON 786.299.5059 1/6/12
Passe
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
ec_
January 06, 2012
For Inspections please call: (305)762 -4949
Page 3 of 47
1 11 1111 1 1111 11111 11111 11111 11111 1 1111 11 11 11 11
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. P6- /1'- '// TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
cFN 2011IR°.086010?
OR Bk 27938 P9 2574; (fps)
RECORDED 12/22/2011 12 :48.14
HARVEY RUVIN► CLERK OF COURT
MIAMI -DADE COUNTY, FLORIDA
LAST PAGE
Space above reserved for use of recording office
1. Leaal description of property and street/address: terrq Rt.-CC-44 Li EAOQTDA) D t ®
0011-1 (3 Prue. rt IA4 ( SW/14 S FL. 33 i3151
2. Description of improvement: Re — S'LV%cA k Pi• 1 (rD /LA-S
3. Owner(s) name and address: DOU .• omit, 3 • ' $n R me. (3 Axle N INt ( St4GRBJ C.. 33 (3$
Interest in property: Fte S(Pi LE
Name and address of fee simple titleholder: dAl 2�{ Z/�i C. _ 8Y Z+ /Jl° S l'
4. Contractor's name, address and phone number., Deign rtJ'e. i14 -S ,
Mom t j1 tel , Ac.. 3 313 �30��� - G 5
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number. NA
Amount of bond $
6. Lender's name and address: NA
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)7., Florida Statutes,
Name, address and phone number
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes.
Name, address and phone number.
9. Expiration date of this Notice of Commencement: :S(3L.`I Z-0( 1
(the expiration date is 1 year from the date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WIT •UR LENDER OR AN ATTOR EY BEFORE COMMENCING WORK
OR RECORDING YOUR OTICE OF COMMENCEMENT. r •� ��"
b�y� � t6pePtfa�� �,, �iofflae
er(s)' Authorized Officer /Director /Part
Prep
Print
Title/
Signature(s) of Ow
Prepared By
Print Name
Title/Office
STATE OF FLORIDA
COUNTY OF MIAMI -DADE
or
• B _� q
ire t 617ANIPIAIRIENW ...,• '..
The foregoing instrument wa accknowleo d before me this Zoe day of Nf✓ 1 �-O 1 l
By 1�)Cr(P�S I. E( CA-O �'
rig Individually, or Zi as for
Personally known, or ❑ produced the following type of identification:
Signature of Notary Public:
Print Name:
(SEAL)
VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES
Under penalties of perjury, I • : clare that I have read the foregoing and
that the facts stated in it ar:�` e, t best of my knowledge and belief.
t141'. 1 I
3ignature(s) of Dwells)
•p••a Fawn N. OWER S ears t
4 ∎'F 44 Come DD0797738 .
«,ash
F: >s 91312012
'4;�'f+Fo, °� I: r'As;^,;e., Inc 5
prized Officer /Director/Partner /Manager who signed above:
By
k5(21.4((
DANAlc
Miami Shores Village
Building Department
90050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: BUILDING
ROOFING
i< /5/.‘e-Jr,"
� ir7�PiPl��
Permit No. OS- t t - 111 q
Master Permit No.
OWNER: N�ame (Fee Simple Titleholder): 7d Phone #:
/ 9 •
Address: / 7
City: /10/?l77 / 6 :4C S�
Tenant/Lessee Name: /f//9
Email:
State:
Zip:
Phone #:
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name:
Address: 942, z"0.
City: Aiff,./ 2'A» State: /7 Zip: _3I
P
Qualifier Name: ,Z1/ Phone #:7,6 22$23
State Certification or Registration #:61� Certificate of Competency #����J ^3 O
Contact Phone #: 7;11‘.
; 2.629 34.5-7Email Address: , a,-, ,' "../P ' /.d09 %F�,f
NO l-
Flood Zone:
Phone#: 7,0:4' ,2.25?- 0
DESIGNER: Architect/Engineer: i'4
Phone #:
Value of Work for this Permit: $ #4; (/(./ Square/Linear Footage of Work:
Type of Work: ❑Addition iteration ❑New DRepair/Replace ❑Demoli ' n
Description of Work: kY7/.4 � /� .�f ��✓ 94 f/ /��
/16)
*************** **: x* ************** ****** Feesu:*: x************ x: *** **** ** ***************+ ***
Submittal Fee $ 50 . GO Permit Fee $ CCF $ CO /CC $
Scanning Fee $ PA t D Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 1 tb ,6* `)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection hich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be , roved ad .d a reinspection fee will be charged.
Signature
�wner or Agent
The foregoing instrument was acknowledged before me this ri
day of -sus, 20 k,\, bycpL ,IA a C)) [C
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
\ \\`.% �lIlwlllitt�'�b
,e•
U_. =
'• 'o o ., �\;
.-..'r S.... il 0 17in 1: \ .‘.N.: \* ' Cs: **************************** ***************** * * **** * ** **** * * ** * * * ** * ******** , : x� *x �x�xx� •x�x�x�x�x�x �x �xx�* *
����� Plans Examiner
Signat
Contractor
The foregoing instrument was acknowledged before me this
day of L , 20 .4, by ). ��' ,
who is personally known to me or who has produced
as identification and whA►ii4 e an oath.
NOTARY PUBLIC
r
��`�
• s S OI Vey.
03
My Commission Expires:
APPROVED BY
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
021 // Zoning
Clerk
0
Planning and Zoning Criteria
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Issue Date: Not Issued
Expires:NOt Issued
Folio Number:1132050090490
Owner's Name: DOUGLAS BISCHOFF
Job Address: 9879 13 Avenue
Miami Shores, FL
Owner's Phone:
Total Square Feet: 1100
Total Job Valuation: $ 4,800.00
Contractor(s)
DECORATIVE MASONRY INC
Phone
(305)757 -7765
Primary Contractor
Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 6/21/2011: Yes
Comments:
STATE OF (FLORIDA)
COUNTY OF (DADE)
Miami Shores Village
Building Department
SURVEY AFFIDAVIT
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
The undersigned Affiant, ibU (i 14-i K. nicie1 adoes hereby attest that
(Property owner)
The attached survey, performed by -t'1' S��' �Yo2S, TA.)
(Name of surveyor's company)
For address: '.1 n) e— l .41/(
Performed on )- 4 °t ( (date of survey) is an accurate representation of the existing conditions and
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property
without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to
remove or obtain permits for any structures which now may exist on the property which are not permitted or which
may violate zoning or building code regulations. The Affiant further understands that the existence of any such
structur41,:y affect final inspections as applicable to this or other permits.
Further, ' _ it naught. it ' ' I
j
3 G--CAS te. at Jr-i4-0;c
Property • er Si, rture Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this 911 day of 5 iL-f— 710 l 1
Affiant is personally known to me, produced i- �,�,1A two as identification.
\,.�`�O....... 6,�% •
.Z"..... ��^ =
_� N oo J=
Gli . o- c_o y ..ems -. LL =
��
. �.. �(
Revised on 5/22/2009/ Revised on 6/12/09
Notary
From:Vanessa Ruiz FaxID:
Page 3 of 3
Date:6/20/2011 04:25 PM Page:3 of 3
Rt® CERTIFICATE OF LIABILITY INSURANCE OP ID VR 1
DATE i
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pofcy(les) must be endorsed. If SUBROGATION I5 WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER
Kahn - Carlin & Company, Inc.
3350 S. Dixie Highway
Miami FL 33133 -9984
Phone :305- 446 -2271 Fax: 305- 448 -3127
I.UIN Ac.
NAME:
PHONE rAA
(NC, No Eat): (NC, No):
ADDRESS:
CK
CUSTOMER ID #. DECOR -1
INSURER(S) AFFORDING COVERAGE
NAIL •
INSURED
Decorative Masonry Inc
842 NE 99th Street
Miami Shores FL 33138
INSURER A: Bankers Insurance Company
INSURER B:
090005330502404
INSURERC:
12/22/11
INSURER D :
$ 1, 0 0 0, 0 0 0
INSURER E :
i Kr-111
PREMISES (Ea o^ urrence)
INSURER F :
GES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TC CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REOUIEMENT, ERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W TH RESPECT TO WHICH HIS
CERTIFICATE MAY BE ISSJED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TIE PO-ICIES DESCRIBEC HEREIN IS SUBJECT TO ALL TFE TERNS
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE OF INSURANCE
INS
POLICY NUMBER
DODO/ trr
(MM/DD/YYY1�
ONDD/Exr
(MM/DD/YY1fY)
LIMITS
A
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITY
OCCJR
090005330502404
1.2/22/10
12/22/11
EACH OCCURRENCE
$ 1, 0 0 0, 0 0 0
X
i Kr-111
PREMISES (Ea o^ urrence)
8100,000
CLAIMS -MADE X
MED EXP ;Any one person:
$ 5 , 0 0 0
PERSONAL BADVINJURY
$ 1,000,000
GENERAL AG3EGATE
$1,000,000
GENt AGGREGATE LIMB APPLIES PER:
PRODLCTS - COMP.OP AGG
$ 1 , 0 0 0 , 0 0 0
POLICY I� JEQ I-7 LOC
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
ION -OWNED AUTOS
COMBINED S NGLE LIMIT
(Ea accident)
$
BODILY INJURY iPe' person)
$
—
BODILY INJURY (Pe- accident)
$
PROPERTY DAMAGE
(Per accident)
$
$
—
UMBRELLA AB L_
EXCESS LIAB
O
CLAWS-MADE
EACH OCCURRENCE
$
AGGREGATE
$
CEDUCTIBLE
RETENTION $
8
$
WO HERS COMPENSATION
AND EMPLOYERS' UABIUTY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICE R /MEMB -R EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION CF OPERATIONS
Y / N
N 1 A
-WC SIATU- 0 TH-
TORY LIMITS I I ER
E.L. EA.CH ACCIDENT
$
below
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POUCY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, IF more apace Is required)
CANCELLATION
Miami Shore village
Building Department
10050 N.E. 2nd Avenue
Miami Shores FL 33138
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CITY -7 0 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
200 At OI.All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks ol'ACORD
3
CERTIFICATE OF LIABILITY INSURANCE
Date
1 6/20/2011
Producer: Lion Insurance Company
2739 U.S. Highway 19 N.
Holiday, FL 34691
(727) 938 -5562
This Certificate is Issued as a matter of information only and confers no rights
upon the Certificate Holder. This Certificate does not amend, extend or altar
the coverage afforded by the policies below.
Insurers Affording Coverage
NAIC *
Insured: South East Employee Leasing Services, Inc.
2739 U.S. Highway 19 N.
Holiday, FL 34691
Insurer A: Lion Insurance Company
11075
Insurers:
Insurer C:
Insurer D:
Insurer E:
Coverages
The policies
this certificate
paid claims.
of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement, term or condition of any contract cr other document with respect to which
may be issued or may pertain, the insurance afforded bythe policies described herein is subject to all the terms, exclusions, and conditions of such poricies. Aggregate limits shown may have been reduced by
LTR
INSRD
Type of Insurance
Policy Number
Policy Effective
(MM/DD/YY)
Policy Expiration Date
(MM/DD/YY)
Limits
GENERAL
LIABILITY
Commercial General Liability
Claims Made ❑ Occur
Each Occurrence
$
Damage to rented premises (EA
occurrence)
$
Med Exp
$
General aggregate limit applies per.
DPolicy Project ❑ LOC
Personal Adv Injury
$
General Aggregate
$
Products - Corrph /Op Agg
$
AUTOMOBILE
LIABILITY
Any Auto
At Owned Autos
Scheduled Autos
Hired Autos
Non -Owned Autos
Combined Single Limit
(EA Accident)
$
Bod y Injury
(Per Person)
g
Bodily Injury
(Per Accident)
$
Property Damage
(Per Accident)
$
EXCESS /UMBRELLA LIABILITY
IOccur ❑ Claims Made
Deducible
Each Occurrence
Aggregate
A
Workers Compensation and
Employers° Liability
Any proprietor /partner /executive officer/member
excluded?
If Yes, describe under special provisions below.
WC 71949
01/01/2011
01/01/2012
X
I wry L
I
I ERH-
E.L. Each Accident
11.000.000
E.L. Disease - Ea Employee
$1,000.000
E.L. Disease - Policy Limits
11,000.000
Other
Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616
Descriptions of Operations /LocatlonsNehicles/Exclusions added by Endorsement/Special Provisions: Client ID: 1942-004
Coverage only applies to active employee(s) of South East Employee Leasing Services, Inc. that are leased to the following "Client Company":
Decorative Masonry
Coverage only applies to injuries Incurred by South East Employee Leasing Services, Inc. active employee(s) , while working in Florida.
Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity.
A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937 -2138 or by calling (727) 938 -5562.
Project Name:
FAX: 305 - 756 -8972 / ISSUE 06 -20-11 (TD)
Begin Date: 5/6/2010
CERTIFICATE HOLDER CANCELLATION
VILLAGE OF MIAMI SHORES
BUI LI DING DEPARTMENT
10060 NE 2ND AVENUE
MIAMI SHORE, FL 33138
Should any of the above described policies be cancelled before the expiration date thereof, the Issuing insurer will
endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no
obligation or Lability of any kind upon the insurer, is agents or representatives.
j,' /�« �p Y
MIAMI -DADE COUNTY
TAX COLLECTOR
140 W. FLAGLER ST.
1st FLOOR
MIAMI, FL 33130
Construct Trades Qualifying Board
BUSINESS CERTIFICATE OF COMPETENCY
000013.558
DECORATIVE MASONRY
D.B.A.:
AUL s DANIEL F
Is certified under the provisions of Chapter 10 of Miami -Dade County
VALID FOR CONTRACTING UNTIL 09/30/202
2010 LOCAL BUSINESS TAX RECEIPT 2011
MIAMI -DADE COUNTY - STATE OF FLORIDA
EXPIRES 4EPT. 30, 2011
MUST BE DISPLAYECgAT PLACE OF BUSINESS
PURSUANT TO COUNTY C o DE CHAPTER 8A - ART. 9 & 10
THIS IS NOT A BILL — DO NOT PAY
RENEWAL
RECEIPT NO. 064689 -4
CC # 000013558
064689 -4
BUSINESS NAME / LOCATION .
DECORATIVE MASONRY INC
842 NE 99 ST
33138 MIAMI SHORES
OWNER
DECORATIVE MASONRY INC
Sec. Type of Business
196 SPECIALTY. BUILDING
THIS IS ONLY A LOCAL
BUSINESS TAX RECEIPT. IT
DOES NOT PERMIT THE
HOLDER TO VIOLATE ANY
EXISTING REGULATORY OR
ZONING LAWS OF THE
COUNTY OR CITIES. NOR
DOES IT EXEMPT THE
HOLDER FROM ANY OTHER
PERMIT OR LICENSE
REQUIRED BY LAW. THIS IS
NOT A CERTIFICATION OF
THE HOLDER'S QUAUFICA-
T1ONS.
PAYMENT RECEIVED
MIAMI -DADE COUNTY TAX
COLLECTOR:
09/30/2010
09010979001
000045.00
SEE OTHER SIDE
FIRST -CLASS
U.S. POSTAGE
PAID
MIAMI, FL
PERMIT NO. 231
WORKER /S
CONTRACTOR 10
DO NOT FORWARD
DECORATIVE MASONRY INC
DANIEL F AULTON PRES
842 NE 99 ST
MIAMI SHORES FL 33138
1„11, „11,,,,11 „11,1,,1„ ,1,1,1,1 „11,,,1,1„ 1,,1„ 1NA,1
5
MIAMI -DADE COUNTY TEMPORARY RECEIPT - COUNTER
mss/ v 20 %/
�
^ NO.58980
RECEIVE FROM: ,`/'771 ti%430a\/W «a)
/1/4)E it4P97141
FOLIO # f 1 it'fthJi W/ DOLLARS
/,
/3/P /8 - I -DADE COUNTY TAX COLLECTOR
AMOUNI'ACCEPTED $_ l
107_01-157 6/09
BY
LL y /1.S., JVV Jt4.11t/1V VV1V •V .
This form is used during the cut off period: June 16 -30.
Write the information with red pen.
2010 -2011
MUNICIPAL CONTRACTOR TEMPORARY RECEIPT
LBTR # 04kOgq-
Name b&NO T /VIC i4A S
o/Q g-y/
Municipal Contractor is restricted to do business in the municipality of
Type of contractor: (4‘1,
Date JUN 2 0 2011
Amount /8"
State/ CC# /365g
q5/77
This temporary receipt is issued as evidence of payment and is valid only until July 15,
2011.
Notice to the Municipality: Accept only original proof of payment, completed in red
ink. Do not accept a copy.
Foy FIRFG'
a e', .
SEP ,op ra-� . . //
Receiver.? an
#9 OF' ,0. 21
3
1. VASQUEZ
treet
found
nail
M
N
set 1/2" rebar
#3284 Concrete Block Wall.
Measured Reber to Water's Edge 151.8'±
Record = 150.0' Measured Reber to Drillhole e 151.25'
H
p
0
x
o
tt
23.40
Sri
N . '41 19.80'
23.35' v
56.40'
concrete walk
2 steps, 1' each
0
oo
fdrTu found
hole
0
Gravel
Drive
concrete
a0)
O
L. U a)
o to 4tii 2 cc)
N
G 03 o
O rL' z
rn
M
0 24.00
U3
0 ,,,
C
—iii_
—WOOD
gfailjr-
50.40'
.00'
Tile
Slab
1
w
° N•E° --St's
0
z
O
< (/)
�o N
pp:* mierty;gexixam
Record 150.0' Measured Rebar to Drillhole = 151.5'
easured Rebar to Water's Edge 151.8'4
set 1 2" rebar Concrete Block Wall
set nail
and disc
#3284
aSeft
1 - There may be additional restriction that are not shown on this survey that may be
found in the Publlc Records of this county.
2 - Examination of ABSTRACT OF TITLE will have to be made to determine recorded
instruments. if any affecting property.
3 - Location and identification of Utilities If any, are shown In accordance with Recorded
Plat.
4 - Ownership is subject to OPINION OF TITLE.
5 - Type of Survey: "BOUNDARY SURVEY"
6 - This Survey is not valid unless signed and sealed by the Surveyor of Record.
7 - Bearings hereon are referred to an assumed value of
for the -
said bearing is identical with the plat of record
8 - Elevations if shown are referred to National Geodetic Vertical Datum of Mean Sea
Level, 1929
Benchmark.
Location Index:
arniZerr
Elevation=
si.10/i1P/
."0
I75- 11 -l119
found .
drill hole-
30' 30'
z
30'
d
150'
2
4-'
o)
.d-
i�
vi
DATE
3
1
7i/I/
`/
BLDG DEPT
,sG /`/
0'
0)
r ..
rn'
LEGAL DESCRIPTION: Lot 4 Block 4
Subdivision FAR .ETON SHORES
according to the Plat thereof as Recorder in Plat Book 4 3
at Page 80 of the Public Records of Dade County, Florida.
DOUGLAS K. BISCHOFF & CONNIE L. BISCHOFF
SURVEY FOR:
9879 NE 13th Avenue, Miami Shores, FL
!HEREBY CERIFY: That the survey of the above captioned property was completed under
my supervision and /or direction, to the best of my knowledge and belief;
this survey meets or exceeds the Minimum Technical Standards set forth
by the Florida Board of Land Surveyors in Chapter 61 G17 Florida
Administrative Code, pursuant to Section 427.027, Florida Statutes.
CERTIFY T 0 : DELTA SLiRVj =Y4RS,1N
DOUGLAS K. BISCHOFF AND CONNIE M. BISCHOFF, HIS WIFL �'�'Y¢..
GIBRALTAR BANK, FSB,,.4r "d'''
ADAM R. SCHIFFMAN, P.A. Y
ATTORNEY'S TITLE INSURANCE FUND, INC.
Miami Shores VUlage
APPROVED
BY
DATE
ZONING DEPT
1
7i/I/
`/
BLDG DEPT
,sG /`/
SUBJECT TO COMPLIANCE WITH ALL FERAL
STATE AND COUNTY RULES AND IVGULAITMEI
H Pres.
Waldo F. Paez
Registered Land Surveyor . 3284
State of Florida
DELTA SURVEY() - S, INC.
LAND SURVEYORS LAND PLANNERS
PHONE: 223 -9907 MIAMI, FLORIDA
12888 S.W. 53rd ST.
SCALE: 1 "= 3'
DATE: 2_9_9 5
APPROVED BY:
DRAWN BY: t i . D
PAEZ I FB: 143 PG: 5 5
REVISED
COMMUNITY NUMBER
120652
PANEL NUMBER SUFFIX DATE OF FIRM INDEX
0093 J 3 -2 - -94
FIRM ZONE
A >J
BASE ROOD ELEVATION
9.0'
s
ETCH OF SURVEY
DRAWING NUMBER
95 -191