BPP-16-1150 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shotes,FL
Phone: (305)795-2204 Fax: (305)756$972
Inspection Number: INSP-257777 PermitNumber: BPP-4-16-1150
Scheduled Inspection Date: October 18,2016 Permit Type: Pools/Whirlpools/Hot Tums
Inspector:Mesa,Michel Inspection Type: Final
Owner: BLANCO,JUAN Work Classification: Addition/Alteration
Job Address:146 NW 92 Street
Miami Shores,FL 33150- Phone Number
Parcel Number 1131010160010
Project: <NONE> - —
Contractor: ONE STOP POOLS&CONSTRUCTION,INC Phone:(305)297-5120
BuildComments
_ Comments
NEW Swimming POOL s PcT R 53-9 0 1 R Ts False
Inspector Comments
Passed
Failed
a
Correction
Needed
Re-inspection [�
Fee J
No Additional lnspecdons can be scheduled until
re-lnspoe ion fee Is paid
October 17,2016 For Inspections please call:(305)752-4949 Page 3 of 40
~ ANTONIO CANELAS,P.E. (�
LIC.No. 74099 " 4
7815 SW 24 ST SUITE 111
MIAMI FL,33155
305 261 0321
Miami Shores Village Date 7-15-16
Building and Zoning Department
Miami Shores,Florida.
Reference: Soil Statement
Residential Swimming Pool
Property of: Juan Blanco
146 NW 92 ST
Miami Shores,FL
To Whom It May Concern:
Soil Statement:
A field visual inspection was conducted on 7-15-16 of the swimming pool excavations for the
above-referenced property.The existing site has been observed and evaluated,and we conclude that
the conditions are similar to those upon which the design was based (allowable bearing capacity
equal to 2000 pso. In addition, we conclude that the soil is adequate to support the Required
Beating Pressure of 650 PSF imposed by the new swimming pool.
If you should have any questions regarding this matter,please do not hesitate to contact us.
Sincerely,
�++����rrrrrrrr
+�10 CA
i
No. 74099 '
°sir Z
�'• STATE OF :y
Antonio Canelas,P.E. ��4�•, ��O R`pP_`:��.
Llc#: 74099 �0�,�S '•'.. •'••'`_� �`,,
S/SNA%-
Attached:Photographs of Excavation
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i Miami Shores Village
10050 N.E.2nd Avenue NW +
+~a6 .Addrtt�I�fA�t
Miami Shores,FL 33138-0000
Phone: (305)795 Pe-2204 � � ,. .,
' . Expiration: 01/07/2017
Project Address Parcel Number Applicant
146 NW 92 Street 1131010160010
Miami Shores, FL 33150- Block: Lot: JUAN BLANCO
Owner Information Address Phone Cell
JUAN BLANCO 146 NW 92 Street
MIAMI shores FL 33150-2229
Contractor(s) Phone Cell Phone
Valuation: $ 17,000.00
ONE STOP POOLS&CONSTRUCTION (305)297-5120
Total Sq Feet: 256
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Fence
Date Denied:
Final
Type of Work:Swimming Pool Occupancy:Private Pool Deck
Additional Info: Bond Return: Wail Steel
Classification:Residential Scanning:4 Review Electrical
Review Electrical
Review Planning
Review Planning
Review Building
Review Building
Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Plumbing
Bond Type-Contractors Bond $500.00 Review Structural
CCF $10.20 Invoice# BPP-4-16-59580
DBPR Fee $7.65 07/11/2016 Credit Card $ 1,034.50 $150.00
DCA Fee $7.65 04/28/2016 Credit Card $ 150.00 $0.00
Education Surcharge $3.40 Bond*:3137
Permit Fee $510.00
Plan Review Fee(Engineer) $120.00
Scanning Fee $12.00
Technology Fee $13.60
Total: $1,184.50
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 stFLIUMBING,
conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit asa responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECT A MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDA rtify tha II the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and z 'n u arm o ,I authorize the above-named contractor to do the work stated.
July 11,2016
Authors ed Signature: ner / Applicant / Contractor / Agent Date
Buildin Department Copy
July 11,2016 1
Miami Shores Village APR 2 s 20%
Building Department --;
I 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
'SCI INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20SI
1 I
BUILDING Master Permit No. f6pp 1 _ -S 0
PE IT APPLICATION Sub Permit No.
rUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [-]RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1�(� ��/ q2-City: Miami Shores ry County: Miami Dade Zig): 3a S-0
Folio/Parcel#: 1 �1®� —of to— Iw 0 C) Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
-OWNER:Name(Fee Simple Titleholder):_ n s(u)co Phone#:
Address• 4(® k)enc q L �,'r
City:W 1 GIM Ia State: � Zip:
tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Phone#: -)
Z�
Address:
City: \a r'l11 State: 'F( zip:. 1 Ua
Qualifier Name: / Phone#. Z 1
State Certification C or Registration#: ) OS 9 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 11 , i 0, Square/Linear Footage of Work!
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ 420 Permit Fee$ 6 rD CCF$ CO/CC$
Scanning Fee$ T 0� Radon Fee$ ®-- DBPR$ 2- ,A Notary$
Technology Fee$ 0 Training/Education Fee$ Double Fee$
Structural Reviews$ Z9to_ Bond$ �57Q Q - 00
TOTAL FEE NOW DUE$ ?2!5�,
(Revised02/24/2014) 1, ®-3�,` s
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC.....
t WNII*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 st be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. in the abse of such posted notice, the
inspection will not be approved and a reinspection fee will be charged. ////// F
J A�
Signature Signature
OWNER or AGENT C¢NTOCTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
da olf lTh 20 1(o by ay P by
I � ( 1- who er nay nowI QkA, UJ rsonallykno n to
me or who has produced as me or who has produce as
identification and who did take an dl,th. identification and who did take an oa
NOTARY PU IC: NOTARY PUBLIC:
Sign 61 Sign _iJ '
o��gy p`e ELLE ESP OS RK 2°�' "`A6n MY CO MISSIO F126847
Print: r `� MY r Print:
IBES:MAY 28,2018 °P Bonded hrcugh 1st StateInsurance
Seal: SOF Bonded through 1 st State Insurance Seal:
APPROVED BY — Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
T • . e
Miami shores Village
Oslo Building Department
10050 N.E.2nd Avenue
��► �� Miami Shores, Florida 33138
�ORIDA Tel: (305) 795.2204
Fax: (305) 756.8972
SURVEY AFFIDAVIT
STATE OF(FLORIDA)
COUNTY OF(DADE)
0000
• • 0000 0000••
The undersigned Affiant, s V ,does hereby attest that •;;••; ease •••; •
(Property owner) 669:69
sees
•
......
The attached survey, performed by ' 'GO
(Name of surveyor's com ny) •
For address: j • . •
,tib " Z - l •'0000 •
, .
. • :0.0:0
.0000.
•
• • • •00.0•
Performed on (®94'date of survey)is an accurate representation of the existing conditions and 0.0 •
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
structures may affect final inspections as applicable to this or other permits.
Fur, a t say eth naught.
M
tbo \�J6Vk,6
PropeA Owner Signature Property Owner Print Name
SWORN TO AND SUB IBED before me this C 1 day of �'`A
Affiant is ersonally known to me, produced as identification.
�ti M{�IJHL��E�+ ,NO�sA-00...... � &
Y :y EW"Sr MA
� F ebtythrough 1st state Insurance
Revised on 5/22/2009/Revised on 6/12/09
, e
♦5�o�s y
d...� Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
SWIMMING POOL OWNER'S CERTIFICATION
Date
Miami Shores Village
Building &Zoning Department ""
. . .... ......
...... .... ......
Attention: Building Official
.... . .. .....
I certify that I am the legal owner of the property described as •*Soso
.. .. .. . ......
located at 14
tow �'St ....:.
In accordance with Section 33-12(f), Cale of Metropolitan Dade County, I certify that I
understand and agree that the swimming pool to be constructed at the above address cannot
be used or filled with water until separate permit has been obtained for an approved safety
barrier, and such barrier erected, inspected and approved.
I further understand that this certification, however, does not eliminate the need for
obtaining a permit and erecting and approved barrier prior to final inspection and use of the
pool.
Legal Owner
Note:This certification is to be submitted with a swimming pool permit application in duplicate.
0 SNORES
` Miami shores Vffillage
Boom-� Building Department
10050 N.E.2nd Avenue
tORiDA Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
NOTICE OF REQUIREMENTS
RESIDENTIAL SWIMMING POOL,SPA AND HOT TUB SAFETY ACT
I (We) acknowledge that a new swimming pool, spa or hot tub will be constructed or installed at
14(o hp� 0.2._-st" Miami Shores, FL, and hereby
affirm that one of the following methods will be used to meet the requirements of Chapter 515,
Florida Statues and the Florida Building Code R4101.17.
Please initial the method(s)to be used:
The pool will be equipped with an approved safety pool cover that complies with ASTM
F1346-91. (Submit Manufacturer's Specifications). ••••
. . .... ......
A continuous,one-piece(child)barrier meeting the requirements of Florida Building Codl••• •,
R4101.17.1.15 will protect the pool perimeter.The plans shall show the fence location ald btdthod oT
attachment, including one end that shall not be removable without the aid of tools. (SAA1 Manufacturees :••••
Specifications). •
.... . .. .....
A combination of non-dwelling walls and fences(screen enclosure,child jgi%%1nasorny,•,• ,,,,,•
fence walls,chain link or wood fence,etc.)will protect the pool perimeter.The plans mustffacify the type .'
and location of all non dwelling walls. Florida Building Code, R4101.17.1 •
. . . . ......
(� . . ■
Q�e 1�JAny combination of protection which incorporates dwelling walls with openings directly lr►te$hg ••••
pool perimeter and all windows and doors will be equipped with exit alarms complying with Florida Buftng•
Code, R4101.17.1.9(Submit Manufacturer's Specifications).
Any combination of protection which incorporates dwelling walls with openings directly into the
pool perimeter and all doors will be equipped with a self-latching device with positive mechanical
latching/locking installed a min.54"above the threshold. If this option is selected,submit plans showing all
types and location of all perimeter protection.The plans must also show the location and type of all
openings,and the hardware type for each location. (Submit Manufacturer's Specifications).
In accordance with the Code,the pool may not be filled with water without compliance with the
Private Swimming P of Safety equirements,and upon expiration of the permit,the pool shall be
presumed to be un f I nd rstand that not having one of the above Installed will constitute a
violation of Chap 5 5 . an d will be considered as committing a misdemeanor of the second
degree, punisha rov ded in Section 775.082 or Section 775.083 F.S.This form must be signed
by the owned n th prime contractor.
T CTO S ATUR AND DATE OWNEM' SIGNATURE D DATE
gni
I'
C NT 0 'S F LEA I T) 0 M L E P
A- LARK
N A PUBL R`'"'P�.° K NO A lay c MISSION#FF 2684
MY CO 7
SSION#FF1 847
EXPIRES:MAY 28,2018 OF EXPIRES:MAY 28,2018
OF Bonded through 1st State Insurance Bonded through 1st State Insurance
ORES
Miami Shores Village
Building Department
��ORI 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RESTRICTIVE COVENANT PROTECTIVE POOL ENCLOSURE
KNOW ALL MEN BY THESE PRESENTS:
WHEREAS,the undersigned— 3u Gv�_. , as)('0 is/are the fee
simple owner(s)of the following described property situated and being in Miami Shores Village, Florida:
Address: 14(f9�Q9 Sfi, MI clwi SWE 9 � 31'5®
Whereas, the undersigned owner(s) kin Won(()
desire to utilize said Lot(s)as a single bui ng site e,arhd thendersigned owner(s)doles)hereby declar
and agree as follows: 00000 6 6 6 6.6
000
I. That the property will not be used in violation of any ordinances of MiaaaSttores VIllaj;o 6646;.
orMiami-Dade County now in effect or hereinafter enacted. 6 60606 4
II. That the purpose of the covenant is to induce Miami Shores Village to isase4a pergttor� ;...•;
pool where the required enclosure is not on the subject property where the•pool is Ibcated. •••••
III. That if any of our adjoining neighbors remove any portion of their fendvor 1,or it 6 6.6. :::::o 6;6 6
our/my property shall fail to meet code requirements for pool barriers,',ie,'Js owner?Ulr "";'
immediately installs a protective enclosure to meet code requirement;ani owll obtain a ...�;.
permit for such fence. :.0.:0
IV. That, I/we,as owner(s)hold Miami Shores Village harmless for any negljTe*e or inj". ;••••,
that results from not having the enclosure. 4 ;
V. If enclosure belongs to said property, I agree to maintain &or replace said enclosure in
the event that is damaged or removed by any case.
NOW, THEREOF,for good and valuable consideration,the undersigned do(es)hereby declare that
he/she will not convey or cause to be conveyed the title to the above property without requiring the
successor in title to abide by all terms and conditions set forth herein.
FURTHER,the undersigned declare(s)that this covenant is intended and shall constitute a
restrictive covenant concerning the use,enjoyment and title to the above property and shall constitute a
covenant running with the land and shall be binding upon the undersigned,his/her successors and assigns
and may only be released by Miami Shores Village,or its successors,in accordance of said Village then in
effec.
OV44ER SI-G—Nr&PRINT OWNER SIGN&PRINT
I Hereby Certify that on this day personally appeared before me 512-11 ILD
and has produced ID# as identifica�and he/she acknowledge that he/she
executed the foregoing,freely and voluntarily,for purposes there in expressed.
SWORN TO AND SUBSCRIBED before me on this—L—day of 0
— i�iP LL IN96ALARK
P 847
(Revised �„ s;2oi s
05/2209 Bonded through 1st State Insurance
4/2812016 SIM Safe Pod Alarm i Techko KoW
S187D Safe Pool Alarm Techko Kobot
7:7)
I BYPASSS�
BYPASS
WARNING!
q �NOT REMOVE • •
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This at"Is •••••• Goes •see••
�! g required for safety .� '' •
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4/28/2016 S187D Salle Pool Alarm I Techko Kobd
• 9V Battery Operation (Not included)
• Low Battery LED Display
• ETL Approved Under UL 2017 Standards
You can't protect your pool 24/7. But the Techko S1 87D Safe Pool Alarm is designed to sound a loud
alert when children or animals enter through a safe pool protected door or gate.
Set it and forget it if you're going on vacation or away from your home for the day. Its "Always On" alarm
protection activates instantly when an entryway is breached, and will sound continuously until the bypass
button is pressed.
The S1 87D is equipped with two bypass buttons allowing entry back from the pool area without sounding
the alarm, and features an additional magnetic sensor so that the alarm can monitor both sliding glass
doors and the screen door. The durable housing makes it suitable for both outdoor and indoor pool
areas.
This water and weather-resistant unit is ETL approved under UL 2017 standards to meet co"spfety
. . .... ......
laws. It operates with a 9-volt battery, and there is a low-battery LED display that4efs t ou know*** Then a .
000 96 ...0: ....:
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battery replacement is needed. •
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Unit Size •
4.75 x 1.625 x 1.75 •' •• 9.99••
PGs./20Ft.: 9,600
999••9
Pcs./40 Ft.: 19,680 •..• ; ••.• ;••••;
Pcs./40 Ft. Hq.: 22,896 •'
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6A_N FLOOD- N/A
CERTIFY TO: FNbl.i FLOOR. N/A
Juan Blanco LOWL.5T N/A
Camillo a Camillo, P.A.
AD.14RADL
Attorneys' Title Insurance Fund, Inc.
C 7-
LEGAL DESCRIFnGN:
Lot: 1
Block:
Subdivision: Miami Shores Manor
According to the Plat thereof as recorded in
Plat Book: 45 Page: 13 to 1
Public Records of DADE County, Florida. •"".
ADDRESS: •• •••• •
146 NW 92 STREET �(� J 0000•• 00.0 ....•
MIAMI SHORES,FL 33150 F/,a / I �? " • :•• F-�n •
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Inspection Worksheet
d\ „ 0 Miami Shores Village
CS�� 10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-268959 Permit Number: BPP-4-16-1150
Inspection Date: October 14, 2016 Permit Type: Pools/Whirlpools/Hot Tubs
Inspector: Dacquisto, David
Inspection Type: Survey Final
Owner: BLANCO,JUAN Work Classification: Addition/Alteration
Job Address:146 NW 92 Street
Miami Shores, FL 33150-
Phone Number
Parcel Number 1131010160010
Project: <NONE>
Contractor: ONE STOP POOLS&CONSTRUCTION, INC Phone: (305)297-5120
Building Department Comments
NEW Swimming POOL Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passe ,�� /�� ��
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections please call: (305)762-4949
October 14,2016 Page 1 of 1
DOUNDAFY SURVEY
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CERTIFY TO: 01NE 901,11 7C. Z m
MARIA RODRIGUEZ Metro FA "Ir 89hSt
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LEGAL DESCRIPTION: 1�r11e R,a�or{ m < 5 E I P o r t o I e y
LOT: I :i:;:; 77.50'(RR)(M) 163.90' B c tl� NVI87111 ST x �'�••• �i,•.
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SUBDIVISION: MIAMI SHORES MANOR -- — � �
n P�V1861h S1 ••• ' •
ACCORDING TO THE PLAT THEREOF AS RECORDED IN • " •
FLP 1/2 + .l.P 1/2 F.I.P 1/2" VICINITY MAP 0 0.6.0 ••• •
PLAT BOOK:45 PAGE: 13 .D yE1� � 6
PUBLIC RECORDS OF MIAMI-DADE COUNTY,FLORIDA r+y � 9p �
609:44 " •••
•/ �• t� � •••e •
y CO �3 PROPERTY ADDRESS: '***so • "o• 6
FLOOD ZONE INFORMATION: m m N �\ 14G NW 92th STREET e e•6 e• • • goes,
THE NFIP FLOOD MAPS HAVE DESIGNATED THE HEREIN rn o MIAMI SHORES, FLORIDA 33150 ••••66 ••: } •'•• '
DESCRIBED LAND TO BE SITUATED IN: ? z ¢ 3.5' 4 P LJ •
FLOOD ZONE: X 3 12.4' ao **ease
Encroachments Noted: NONE • • • • J ,•• •
PANEL NO/SUFFIX: 302/L N N 2 ,, 13.1 • • 000 • Us. 6
COMMUNITY NO.: 120G52 g' �17 30 x tip ••• e e
DATE OF FIRM: 08/18/2014 `� MHi�/ ON PL. •• • 6" • 1
THE SUBJECT PROPERTY DOES NOT LIE IN A x •' ° �n
'3s 45' x E -'IT : �V 16- 11 �a
SPECIAL FLOOD HAZARD AREA 10.60' �-
' Miami Shr_re,V111age Orn
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ago ONE STORY X AP P R O'v ED I=
I °f RES No.146 / x _ BY DATE
P
1 20. 0 >4 Z_CPJ!^JG DEPT
10.50' 12.60' '1
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Notes: x x moi" ///^ Pio m E BLDG DEFT
A)AD Clemanoes and/or encroachments shown `' I iu t0 ;/ 3.0' x LOT 2
M aro of apparent nubm Fence ammah p0 0.55 CL. o\?�"�'\ 0.50 ^ 5.0' x 0O
by visud means.Legal ownership of falces not �. �' SUBJECT 10 CGNIP11410E WI FH ALL FEDERAL
detamLned.
B this bz intended for m e or reRnmme �I' I DECK
•Y o i N STATE ANu(Y i_)N,Y HULLS AND REGULATIONS
purposes only ercdU011 far the use o, those to CV 19.3 �
wham ft Ts aertifted.This survey is not to be used I x
far aornetruotian.permiftGng,de�n��my other I 23.3' x
use wfthout wrftten ooment of TFFii d Kepy.Ina
C)Code restriction and title a m, 11 arex an this survey. not rofleated to I
Q)The ft ma
Infatton shown hereon does not imply I x L.EGM OF SURVEY ABI3FL: AATM ry
that the referenced property wig or will not be free I x D
from Hooding or damage anyyd does not arcate ilab9ity I x V)
an the part of the firm any results from ae on ~ I LLL��� I� A/
thero0f far- damage xl A$q1.PAV.J45WHALPAw7iENT "Va_,_A47•M e
1W0-1
E)7he maids dsuapioted hereon were surveyed per the `o J I e a_ p COMMoTva_rrOr m sm vemcAi oAnsr 0-
legd daoiption end no claims as to armerehlp or I M O` Y I e sm ED=maarr re=LOWa vnm�
matters of title aro made or implied. Cl) � AW iai�a Gum
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Undergraeend Enaaadur►mt0.H mqb not boated x a+_._.�MST*= P.C....__JV81T aF CURVATUM z
0 I hereby oerlify that the eeuurrwwyy represented I x au.F__9HM eAa FE= PAC T ca+ma SAM �
hereon meats the minimum tedeniod standards aP__aaewanr Pare
est forth by the Blood of Land�rysyo�s x aA
In Chapter 5d-17.050 to 17.062 arida I I r _ 9 nsoae ma snrcco PMrx.._._PAeaeeAT CO
Admftletrative Code persumn �a P K�..�.PAWOA YMaPi
027 Flastutes I + 7.7' I ry _, �'s� ^• Y Fnmm+r P Guam sa+&Tas
to Sectlan N)If sham, bearings are to an assumed meridian .�6 a�DOW P.o.s----Annn w amaasa
p q Q a_„_cm PAC SON AO a c OM CUR+r
I�If ehawn, devotions aro referred to N.QV.D.1929 0.2'CL. I gO��GI 96' is 25 CL. Ol. 2016 0y ��2Asnm+r PRGaTeT
J)ThIs ie a boundary envoy �� , u -""" � P.T �
Lx x x ' " �_ a+2�usuaom+ra lsssr,r YF"wMn 09/15/16
m 4 QNLF 4 ALF 4 67/LF - _ - - - F.I.P 112
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UNLESS IMPRINTED WITH EMBOSSED SURVEYORS SEAL
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