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PW-10-1632Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 9617 PARK Drive Miami Shores, FL Owner Information Expirati • n: 12/12/2010 Parcel Number Applicant 1132060172350 Block: Lot: MIAMI SHOR ° S VILLAGE Address Phone Cell MIAMI SHORES VILLAGE 4/". AMMONMAAPIENIVOIROM.4.4WCW'''',, Valuation: Total Sq Feet: Scanning: 1 Fees Due CCF Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $o.00 $o.00 $o.00 $o.00 $o.00 $0.00 Pay Date Pay Type Amt Paid Amt Due Invoice # PW -9 -10 -38909 $ 0.00 $ ,200.00 Available Insp ctions: Excavation In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordi antes and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of iami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. 1 understand th t separate permits are required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. September 13, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date September 13, 2010 1 COUNTY • • • •• • • • • • • • • • • •••• • • •••• • • •• .• • • • • • • •••• • • • •• • • .••• • September 13, 2010 Miami Shores Village Building Department c/o Mr. Claudio Grande, CBO Building Official /Director 10050 NE 2 Avenue Miami Shores, FL 33138 -2382 Re: Water Service Installation for: 10015 PARK DR AFA # 234 ER # 16399 Dear Mr. Grande: Water & Sewer P.O. Box 330316 • 3071 SW 38th Avenue Miami, Florida 33233 -0316 T 305 - 665 -7471 miamidade.gov Rio 0 -- u2(Y/_ Transmitted herewith for your approval and permit is one (1) set of the permit application and two (2) sets of the water service installation referenced above. Upon approval and issuance of the permit, it is requested that you return to us one copy of the approved sketch and the original permit. If your approval and issuance of the permit has special restoration requirements, we will need to notify the customer of the additional charges involved with the installation. Please inform us if there will be special restoration requirements for this permit request. Should you have any questions regarding this matter, please advise. •� Sincerely, • • • • • . • • • • • • • New Customer Division • • • • • • • • • Office: 786 -268 -5259 ARETA01@miamidade.gov Miami Shores Village Public Works Department 10050 N.E. 2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Far (305) 756.8972 Public Works Permit Application FBC 2004 Pena Type: Public Wallet WATER Pennii No. Owner's Name (Fee Simple Titleholder) Phone It: Owner's Address City .. Tenant/ Lessee Nana Phone is Job Addmss (where the viat is bdeg dwre) 1 orb 1e Vr V It City Miami Shores Village County Miami Dade Is BuUdlnp Historically Designated: YES NO . ji Connecta % Company Nameej� MAW /�'©AC*IOW. Contractor's Address ,/,11 •�1 00,114' �- �ry /� City 1 _iit S J aP ArchttecVEngineers Name (if applicable) /�' 1' fOrti* "N, v Phone It: 1 S(EJ� •�r � $ Value of Work For fhb Pam* . I �d!!�y 6 Lineal Footage Of Work Phone *. &)a0A0lWel Type of Work: Describe Work: Submittal Fee $ •••• • • Node j . • . Training/Education Fee $ Technology Fee $ • • • • • • • Staining Radon $ Zoning Bond $ • • • • • • • Coda Enforcerrrent% i • • i Structural Plan Review $ • ❑ Addition ❑ Alteration ❑ New 0 Repair/Replace ❑ Demolition %t 1 lli OW id r'1 g' 10019 1 -. Fees .................... Permit Fee $ /04*.? CCF $ CO/CC •• •• •• •• • • • • • • • • Total Fee Now Du/ • • • • • 0000 (%bntinued an opposk i • •000 • • • • • • • • • • •• • 0000 • • • • •• • • • • • Bonding Company's Name (If applicable) Bonding.CorppanVs Address N/A City State Zip Mortgage Lenders Name ('d applicable) N/A Mortgage Lender's Address Cfiy State 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 constnjcton in finis jurisdiction. I understand that a separate pemrfi must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CbNDMONERS, 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 this issuance of a Public Works permit with an estimated value exceeding $2500, Ibe appircantmust promise br good faith that a copy of the notice of commencement and construction Gel► law brochure will be led to Me person whose properly lssubject to atlachnnent Also, a ceGGed copy of Me recorded notice of cornmeecemen tmust be , • _4 : , at the job sae forthe End Inspection which occurs sewer (7) days after the buliding permit Is issued In the absence of such posted notice. the inspecGOn will riot be approved and a reinspection fee will be changed Signature Signature 'AO eiffl Contractor The foregoing instrument was acknowledged before Me^ this t • The foregoing instrument was admowledged before me this 7 day of l 20 r by l`��'S? ke day of 20412 by A•.� who is personally known to me or who has produced R. ! Who is personally know to me has produced . I as identification and `v tellittiddira9 oath. NOTARY PUBLIC: `�a\ 6 •.. °'° ,� io.� Sign: / , �y =��.'' • :s. Sign: —n : v. v, f �� - ^' �: = Print: Irle ......... - y. as identification and who did take an oath. Print: My Commission Expires: APPLICATION APPROVED BY: 11/17/2005 OTARY PUB : My Commission V -LACAU ' MY COMMISSION # DD770572 %►Q,; EXPIRES April 10, 2012 •• • • • • • • FI• "'v"JJ9ti ice.com •••• • Publiy' Wojcs,3irector'or his desigtitd.• •• •• • • •••• • • ••• • • • • •• •• • • • • • • • • •••• • • • •• • • •• • • • • • • •••• • • • • • • • • • • • • • • • • • • VILLAGE OF MIAMI SHORES MIAMI -DADE COUNTY SEC. 6 -53-42 NEW 1" SINGLE SERVICE SET BOX AND SPACER LOCATE SOUTH OF PLAYGROUND N.E. 101 STREET EXISTING 6" WATER MAIN MATERIAL AND LOCATION TO BE FIELD VERIFIED GRAND CONCOURSE SCALE: N.T.S. ..••.GENERAL'. NOTES 1,48 HOURS BEFORE bIGGING CALL SUNSHINE •;.$jhTE ONES• ALL • 2" �.ANE CL DSURES PER•P.D!O.T. DESIGN ' 3'ANDARQJNAEX # 605!• :3 fi''pj1/EMENT RESTORAV6N PER M.D.C.P. W.M. R -21.1. • 6IDEWAL44 STORMIQAI PER M.D.C.P. W.M. R -13.1 i91 MAINTAN aIa 30" GO•FaR ON ALL SERVICE LINES. . "6!"1:10 NOT.SE1NIETE2FS) At THIS TIME. ��► •••. DRAWN: H.B. I DATE: 8/23/2010 1 CKD; NEW WATER SERVICE FOR 10015 PARK DRIVE "CHILDREN PLAYGROUND" A. R. AFA -234 ER -16399 MIAMI - DA rE WATER AND SEWER DEPARTMENT J • • • •. •• • • • • • • • • ••. • • • ••• • • • • • • • • • • • • • • • • • • ••• • • • • • • • • • • - --- • • • • ••• • • • • • • • • •• • • • • •• • ••• • •• •• • • • • • • • • • • • • • ••• • ••• • • • • • • • • • • • •• • • • •• ••1 •• �. . • �1' • • • J • ■ ■■ riri/7'/ ■ WorksMe • Less Than r 200' l 400'I J � � ( J SYMBOLS Work Area 0 Sign With 18" x 18" (Min.) v Orange Flag And Type 6 Light • Chonnelizing Device (See Index No. 600) ()r Work Zone Sign Flogger Lane Identification + Direction of Traffic More Than 200' GENERAL NOTES 1. Work operations shall be confined to one travel lane, leaving the opposing travel lane open to traffic. 2. When vehicles in a parking zone block the line of sight to TCZ signs or when TCZ signs encroach on a normalpedestrion walkway, the signs shot be post mounted and located in accordance with Index 14a. 17302. 3. If work area is confined to an outside auxiliary lone, the work area shall be barricaded and the FLAGGER signs replaced by ROAD WORK AHEAD signs. Flaggers are not required. 4. Flaggers shall be in sight of each other or in direct communication of all times. 5. The FLAGGER legend sign may be substituted for the symbol sign. 6. The maximum spacing between devices shall be no greater than 25.' 7. For general TCZ requirements and additionalinfarmation, refer to Index No. 600. 8. The two channelizing devices directly in front and directly at the end of the work area may be omitted provided vehicles in the work area have high - intensity rotating, flashing, oscillating, or strobe lights operating. CONDITIONS WHERE ANY VEHICLE, EQUIPMENT, WORKERS OR THEIR ACTIVITIES ENCROACH ON THE PAVEMENT REQUIRING THE CLOSURE OF ONE TRAFFIC LANE, FOR WORK AREAS LESS THAN 200'DOWNSTREAM FROM AN INTERSECTION FOR A PERIOD OF MORE THAN 60 MINUTES. CONDITIONS WHERE ANY VEHICLE, EQUIPMENT, WORKERS 01? THEIR ACTIVITIES ENCROACH ON THE PAVEMENT REQUIRING THE CLOSURE OF ONE TRAFFIC LANE, FOR WORK AREAS 200'OR MORE DOWNSTREAM FROM AN INTERSECTION FOR .4 PERIOD OF MORE THAN 60 MINUTES. DURATION NOTES 1. ROAD WORK AHEAD sign may be omitted if allot the following conditions are met' al b) c) dl el Work operations are 60 minutes or less. Speed is 45 mph or leas. No sight obstructions to vehicles approaching the work area for a distance of 600 feet. Vehicles in the work area have high - intensity, rotating, Bashing, oscillating, or strobe tights operating. Volume and complexity of the roadway has been considered. 0 TWO -LANE TWO -WAY, WORK NEAR INTERSECTION 2010 FOOT Design Standards Sheet No. 07/01/09 1 of 1 605 PUBLIC WORKS DEPARTMENT MIAMI -DADE COUNTY Work Information Form (To be completed by all agencies planning to perform construction on Miami -Ddade County road rights -of -way). --!!-- 1. Have the roads, which are impacted by the proposed work recently been paved or surfaced? ❑ Yes IN'No 2. Briefly state type of construction to be performed and the location boundaries of the work: NEW 1" DOMESTIC SERVICE FOR: 10015 PARK DRIVE. TO BE INSTALLED ON THE EAST SIDE OF PARK DRIVE SOUTH OF CHILDREN'S PLAYGROUND, CROSSING PAVEMENT 3. Will this construction affect, in any way, normal traffic flow? 4. Will work be started within 15 days of permit issuance? 5. If no, state estimated starting date WITHIN 30 DAYS ± 2/Yes ❑No ❑Yes IS4o 6. Will work continue on a 24 hour basis until normal traffic is resumed? iSfes ❑No 7. Please provide an estimate of construction time for which traffic flow will be affected. (1- WORIKING DAY) 8. Provide the number and direction of lanes affected by construction. North 1 South 1 East West 9. Does construction work pass through a signalized intersection or mid -block pedestrian signal? ❑ Yes R(No (If yes, see Special Provisions below). 10. Does trench or excavation fall within the paved roadway? IgYes ❑DNo 11. Will work damage existing sidewalk, curbs and gutters? ❑ Yes 12/No 12. Give dimensions (from edge of pavement) showing cut or trenching CUT ACROSS PAVEMENT APPROXIMATELY 22 TO 24 FT. 13. List name and telephone number of person to contact if further information is needed JOSE VILLIERS NEW BUSINESS SUPERVISOR 786- 268 -5367 14. Please provide e-mail address. JVILL@miamidade.gov • • 0000 .SPACIAL PROVISIONS - SIGNALIZATION IN CONSTRUCTION AREA • • • • Anyy construQt+gn•w rk whic(I affebts the operation and/or maintenance of a signalization (signalized intersection, mid - block, flashing • •sighAaT, flashint sigrf, require the contractor to accept responsibility for the operation and maintenance of the signalization Am the date aPhd time thatfrltbegins until such time as the work is complete, the signalization is retumed to normal operation, and • tts1 ttors ftpfrlt ,Public•We e'Department have re- accepted it for operation and maintenance. Between the start and end dates, the tbrector shall employ theseraiees of an officially approved signalization subcontractor who will provide 24 -hour on -call maintenance btra osignaliatigg end si naliestion related equipment in complete accordance with the current version of the "Miami -Dade County Apectal Provisions:or/ ra +raSigiial Construction and Maintenance." • • • �� • • MIAMI -DADE WATER & SEWER 786- 268 -5200 •• Signat�I • Company 0000 • • •• • • Telephone No. THIS FORM MUST ACCOMPANY PERMIT APPLICATION