10-649-001COUNTY.
VERIFICATION FORM
EXPIRES ONE YEAR FROM DATE ON FORM
Water '& Sewer
P.O. Box 330316 • 3071 SW 38th Avenue
- Miami, Florida 33233 -0316
T 305 -665 -7471
miamidade.gov
ATLAS PAGE: M -18 INV#: FORM #: 201027158 DATE: 10/27/2010
NAME OF OWNER: DR PEREZ MEDICAL OFFICE
PROPERTY ADDRESS: 7000 SW 62 ST #545
7=7 --
PROPOSED USAGE / A539 SF MEDICAL OFFICE W/ DOCTOR
NO. OF UNITS:
REPLACES: PREVIOUS !MEDICAL OFFICE W/ DOCTOR (OCLA)
USAGE / NO. OF UNITS: j
PROPERTY LEGAL: 1;25 54 40 1.12 AC M/L E330.87FT OF S130FT OF N245FT OF SE1 14 OF 5E V4 OF 5vv114
FOLIO NUMBER: �` 09 -4025- 000-0591 i GALLONS PER DAY INCREASE 0
PREVIOUS FLOW: 308 PREVIOUS SQUARE FOOTAGE: j 1,5391 ❑ NEW CONSTRUCTION
PROPOSED FLOW: 308 PROPOSED SQUARE FOOTAGE 1,539 ®INTERIOR RENOVATION
THIS IS TO CERTIFY THAT THE MIAMI -DADE WATER AND SEWER DEPARTMENT DOES HAVE A(N) _16_ INCH
WATER MAIN ABUTTING THE SUBJECT LEGALLY DESCRIBED PROPERTY. WE ARE WILLING TO SERVE THE SUBJECT
PROPERTY, (OR, IF "WILL HAVE ", UPON PROPER CONVEYANCE AND PLACEMENT INTO SERVICE OF WATER FACILITIES
BY THE DEVELOPER UNDER AGREEMENT WITH THE DEPARTMENT, (AGREEMENT ID # N /A) SUBJECT TO PROHIBITIONS
OR RESTRICTIONS OF GOVERNMENTAL AGENCIES HAVING JURISDICTION OVER MATTERS OF WATER SUPPLY OR
WITHDRAWAL.
BY:
9S TU OF REPRESENTATIVE
Judy R. Elliott - New Business
Representative
NEW BUS SS CO MENTS: EXIST PS # 8020788654 W/S VF $150.00 PD INV # 126169
PLANS REVIEW COMMENTS:
CRITERIA: C513 - N/A
AUTHORIZED BY
THIS IS TO CERTIFY THAT THE MIAMI -DADE WATER AND SEWER DEPARTMENT D, A(N) 15; INCH
GRAVITY SEWER MAIN ABUTTING THE SUBJECT LEGALLY DESCRIBED PROPERTY E ILLIN 'Tk}pSERVE
THE SUBJECT PROPERTY, (OR, IF 'WILL HAVE ", UPON PROPER CONVEYANCE AND PLP gEI(AEN OF SEWER
SEWER FACILITIES BY THE DEVELOPER UNDER AGREEMENT WITH THE DEPATME (AGREEMENT ID # N/A).
SUBJECT TO PROHIBITIONS OR RESTRICTIONS OF GOVERNMENTAL AGENCIES HAVI G JURISDICTION OVER MATTERS
OF SEWAGE DISPOSAL. FURTHERMORE, APPROVAL OF ALL SEWAGE FLOWS INTO THE DEPARTMENTS SYSTEM MUST
BE OBTAINED FROM D.E.R.M. THE ANTICIPATED DAILY WATER AND /OR SEWAGE FLOW FOR THIS PROJECT WILL BE: NO
GALLONS 101 GALLONS PER DAY INCREASE.
Judy R. Elliott - New Business
Representative
BY:
91GNA RE �OF REPRESENTATIVE AUTHORIZED BY
NEW INES OMMENTS:
PLANS REVIEW COMMENTS:
CONTACT NAME: PHILIP MATTAR
CONTACT PHONE (954) 583 -9990
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k /_ /
D.E.R.M. SEWER EEOS DATED: 10/01/2010 NO NET INCREASE PER RAMON TORRECH
10/20/10 APP # 2010- WDU -PR -10305
)Printed On 10/27/2010 NB. Judy R. Elliott
1
12:04:27 PM
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