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HomeMy WebLinkAboutBack-Up DocumentNtAM Water and Sewer PO Box 330316 Miami, Florida 33233-0316 T 786-268-5360 F 786-268-5150 *ATTENTION! COVID-19 PROCEDURE UPDATE - PLEASE READ. FAILURE TO DO MAY RESULT IN FURTHER DELAYS* Re: Conveyance Documents for the Project GROVE BAY PARKING GARAGE — PHASE 2 - Agreement 1D# 22909 Dear Sir or Madam: Due to the current situation, we are experiencing many challenges in conveyance procedure, and working hard to accommodate our customers. Your safety and the efficiency of our unit is very important to us. Please read this letter carefully. We are all in this together, and we thank you in advance for your patience and understanding. BEFORE bringing in documentation upload any and all conveyance documents to e -builder FIRST, for our review. This will save unnecessary trips to our office it there is an error or a revision needed - After depositing any cgRKe ance documentation into the Conveyance box in the Le'eune office lobby. send an email to our Conveyance Unit Distribution List at WASD-Conve anc mlamidade. oV to noti us that you have dropped off items. This is very impgrtant to ensure proficient, timely processing. The Miami -Dade Water and Sewer Department (Department) is enclosing the documents and forms listed in the table below for the execution by the appropriate parties which cover the water and sewer facilities installed for the above referenced project- # 1 Type of Document Absolute Bill of Sale Requested to Developer 1 Owner Received Date Comments 2 Final Waiver and Release of Lien - Developer Developer i Owner 3 Final Waiver and Release of Lien - Contractor Contractor 4 Warranty Letter Contractor 5 Bill of Materials 1 Cost Breakdown Contractor 4120/2020 6 Grant of Easement Land Owner 7 Easement- Legal Descri tion Developer I Owner 412012020 8 Opinion of Title Owner's Attorney 9 Maintenance Bond 1 Letter of Credit Contractor 10 1 W-9 I Developer 1 Owner 11 1 Recording Fees- EasementDq)Wo er 1 Owner Please provide a one (1) year Maintenance Bond OR Letter of Credit, to cover the cost of the facilities installed, in the amount of twenty-tive percent (25%) for water main facilities, fifty ;percent (509'x) for the sewer main facilities. The amount of the Maintenance Bond has been finalized by the Department's approval of the submitted amounts on the Cost Breakdown (Exhibit 8, included), and $0.00. The Grant of Easement will be required along with an ©pinion of Title confirming ownership of the property encumbered by the easements- Payment of the recording fees in the amount of $10.00 for the first page and $8.50 for each additional page is required for the Grant of Easement document. Please make check payable to ' W'ASD " Or, after requesting and receiving an invoice from the Conveyance Unit, you may pay online at: http://www_miamidade_goy/water/construction-development-payments. asp The table below details the total fixed amount to be paid. Page 1 of 2 Mal Fixed Fee + The approved building plans shall be required for final review before the mater(s) are scheduled. The New Account Work Form, included in the package, can be completed and submitted any lime, along with a copy of the approved building plans, in order to expedite the process of the retail account(s), by filling out all the highlighted areas, signing and emailing it to NewBusinesssupvlistOmiamidade.gov. Once the project receives the construction completion approval and subsequently all the proper documents for conveyance are submitted, the meter(s) may be scheduled. *PLEASE MAKE. SURE YOU HAVE SCHEDULED YOUR FINAL INSPECTION WITH YOUR WASD INSPECTOR, AND THAT THEY HAVE RECEIVED ALL REQUIRED ITEMS. IF INSPECTIONS REQUIREMENTS HAVE NOT BEEN MET CONVEYANCE CAN NOT MOVE FORWARD. *All documents executed by a co oration must have the corporation seal affixedand Rlegse take particular nate that NO CONVEYANCE DOCUMENTS INCLUDING THE MAINTENANCE BOND OR LETTER OF CREDIT IF NECESSARY). WILL BE ACCEPTED IF DATED BEFORE INSPECTIONS HAS ISSUED A NOTICE OF COMPLETION which Includes recelying all required Items, includinn final Inspection. * Please feel free to email us if there are any questions or anything that needs clarifying. Let's work together to limit unnecessary trips or risks. Thank you very much. Truly Yours, New ess Conveyance Unit Dan_DelMazo@miamidade.gov Garoiina.ribeiro@miamidade_gov "Note: Exhibits A & B as mentioned in the Absolute Bill of Sale, Waiver and Release of Lien — Developer, Waiver and Release of Lien — Contractor, and Warranty are only attached to the Absolute Bill of Sale ID 1. 22909 ABSOLUTE BILL OF SALE KNOW ALL MEN BY THESE PRESENTS, CITY OF MIAMI, A MUNICIPAL CORPORATION OF THE STATE OF FLORIDA, hereinafter called GRANTOR which term shall include the singular or plural as the context shall require, for and in consideration of the sum of Ten Dollars [$10.00] and other good and valuable consideration, paid and delivered by MIAMI-DADE COUNTY, a political subdivision of the State of Florida, hereinafter called GRANTEE, the receipt whereof is hereby acknowledged, has granted, bargained, sold, transferred and delivered, and by these presents does grant, bargain, sell, transfer and deliver unto the GRANTEE, its successors and assigns, the following: All water & sewer facilities built and constructed to serve Grove Bay Parking Garage - PHASE 2, DW 2016-144 Z DS 2016-573, ip# 22909 located in Section 22-54-41, Miami - Dade County, Florida, as shown on Exhibit "A" attached hereto and made a part hereof and as more particularly described on Exhibit "B" attached hereto and made a part hereof. TO HAVE AND TO HOLD the same unto the GRANTEE, its successors and assigns forever. GRANTOR does covenant to and with the GRANTEE, its successors and assigns, that GRANTOR is the lawful owner of the above described; that said property is free from all encumbrances; that GRANTOR has good right to sell the same aforesaid; that the GRANTOR will warrant and defend the sale of the said property unto the GRANTEE, its successors and assigns, against the lawful claims and demands of all persons whomsoever. IN WITNESS WHEREOF, the GRANTOR has hereunto set its hand and seal, this day of ATTEST: 20 _ By. Signature Tadd B. Hannon, City Clerk STATE OF FLORIDA COUNTY OF MIAMI -DADS CITY OF MIAMI, A MUNICIPAL CORPORATION OF THE STATE OF FLORIDA Signature Arthur Noriega, city Manager The foregoing instrument was acknowledged before me this day of , 20by Arthur Noriega, as City Manager and Todd B. Hannon, as Secretary, of CITY OF MIAMI, A MUNICIPAL CORPORATION OF THE STATE OF FLORIDA. He/She/They are personally known to me or have produced identification and did/did not take an oath. NOTARY PUBLIC PRINT NAME SERIAL NUMBER as 6' DIP MANIFOLD 6' CATE VALVE 61XI2' DIP TEE 6' GATE VALVE 6'Xi2' DIP TEE 6' GATE VAI 6'X12' DIP 1 MIAMI-DADE COUNTY SEC. 22 TOWNSHIP, 54 RANGE. 41 THIS IS NOT AN ASBUILT THIS IS NOT A SURVEY PLKL "TUKANI LEGEND WATER MAIN - ABANDONED OR REMOVED • ' • ' 1-11f17Z,41/. WATER MAIN -EXISTING ' ' . . . . . . . ' . . . . ------- WATER MAIN - NEW . . . . . . • . . ' ' . . . . GATE VALVE 1 BUTTERFLY VALVE - EXISTING • ' ' • ' pQ GATE VALVE 1 BUTTERFLY VALVE - NEW ' ' ' . ' ' ' H TAPPING SLEEVE & VALVE ' ' . ' ' • ' • ' ' ' . �/ f SINGLE SERVICE . . . . . . . . . . . . ' . . . . -� WATER FACILITIES EXHIBIT "A" N SCALE: NTS, DUAL SERVICE • . . . . . . . • . . . . . . . . . 2" SERVICE . . . . . . . . . . . . . . . . . . . . 4" SERVICE . . . . . . . . . . . . . . . . . . . . TURBINE METER . . . . . . . . . . . . . . . . . FIRE HYDRANT ASSEMBLY • • • • • ' . . • • • • . FIRELINE . . . . . . . . . . . . . . . . . . . . . -� OF ABSOLUTE HILL OF SALE PROJECT NAME: GROVE BAY PARKING GARAGE PROJECT LOCATION: 3540 PAN AMERICAN DR. MIAMI 33133 CONTRACTOR. GPE ENGINEERING & GENERAL CONTRACTOR CORP. 11107/2019 1 AGREEMENT ID #! 22909 DW 2016-144 SHEET i OF 1 htfAMl•TIRt]E � PF•I A 1i fir, •t pie. � u: ri ��,ac = ,r:, � _� •.- Agreement ID#: Project Name: Project Location: EXHIBIT B Miami -'Dade Woler and Sewer Deportment Water 13111 of Materials (Cost broakdown For Donation Projects 2&?%g W YOW rna P. rL�[at �^1P'a r kC i Y7h C^intrav+ fp. �. i���G15P it 1 L Contractor; CZ Pe E Y1 qjn a r' n Q Pnern) C1OY4 a.c.i,vr COV, Inspector: v .n TYPEIMaterial Sll Quantity Minimum Unit Cast Actual Unit Cast Total Cast Local Water Main IncllFittings DISTRIBUTN D.I.P. 6' U. _ $64.00 D.I.P. a' L.F. $70.00 D.I.P. 12' of L.F. $80.00 4160.co D.I.P. 16' L.F. $130,00 Reglonal Water Main incliFittings DIS T RIBUTN A.I.P. 24' L.F. $140,00 W.P. 38" L.F. $2.10.00 Valves: DISTRIBUTN GatetTappling 6' Each 3600.00 GaWrapping r Each $920.00 Gate[Tapping 12' Each $2,300.00 a3CC) -00 6W, QQ— GatelTapping 16' Each $5.100.00 Water Sarvtce; DISTRSVGS Single 1' Each $1,800.00t GU• �+ Dual t' Each $1,900.00 2' Service 2' Each $2,300.00 BW - 00 QQ. 4' Service 4' Each $3,300.00 Turbo 4' Each $11.500.00 Turbo 6` Each $11,640.00 Turbo 8' Each $12,100.00 Turbo 10' Each $12,400.00 Flreline Lateral: DISTRSVCS D.I.P. 4' Each $3,200.00 € J,P. 6' 4— Each $3,500.00 4 3 67CO• 00 3 D.I.P. B. Each $5.300.00 Fire Hydrant: DISTRI•YDR D.I.P. 6" � Each $3,900.00 � qC0. Qp Bond Amount (WASD) $ Tata[ Protect Cost IRestoration and labor must ba Included In unit casts "Re glen aI WM 24 -incites or greater Lo cal:- Wtd Iess than 24 -Inches The back of this document may be used to write in additional Certified by contractor: Signature: Type, size q antity Inspected by: Signature: Dale; Y�L Print: Recelved by ew Bu mess Rep: Signals Date; ZG 't c Prim if needed. r' --,J P k vni G. i rruir4V is nVr%r=civicsv 1 ru 1F . cc.IUL uJ Cult]-0Ili iviiiirnr-rJiiL1C Uvv1Y 1 SEC. 22 1 + V i TOWNSHIP. 54 RANGE. 41 S 1 �i �} _5ToRjr �p ARKINC DA \ \\ % * THIS IS NOT AN ASBUILT THIS IS NOT A SURVEY LEGEND GRAVITY MAIN 1 FORCE MAIN - EXISTING • • • -----•-- TAPPING SLEEVE & VALVE • • • • • • • • • . • • GRAVITY MAIN I FORCE MAIN - NEW • . • • • CHECK VALVE BURIED . • • • • • • • • . . • • N MANHOLE EXISTING . . . . . . • . . . . . .0 CHECK VALVE IN MANHOLE • • • . . . . . . - . • MANHOLE -NEW . . . . • . . . . . . . . • . 0 PUMP STATION . . • . . . . . . . . . . . . . . SEWER LATERAL . . . . . . . . . .. . . • • . GENERATOR HOUSING . . . . • • • • . • • • . GATE VALVE I PLUG VALVE - EXISTING• • • • • • GENERATOR • • • • • • • • • • • . • . • . • • GATE VALVE I PLUG VALVE - NEW• • . . • • • . GRAWYLWNIFORCE MAN •ABANDONEDORREMOVED • . . . . ..7,V/ '7W/, SEWER FACILITIES EXHIBIT "A" OF ABSOLUTE BILL OF SALE PROJECT NAME: GROVE BAY PARKING GARAGE PROJECT LOCATION: 3500 PAN AMERICAN DR. MIAMI 33133 CONTRACTOR: GPE ENGINEERING & GENERAL CONTRACTOR CORP. vni G. i rruir4V is nVr%r=civicsv 1 ru 1F . cc.IUL uJ Cult]-0Ili MIAMO A4' ) :AM) Agreement IDfV Project Name; Project Location; Contractor: Inspector: EXHIBIT B Miami-©ade Water and Sewer Department Wastewater 8111 of Materials ICost Breakdown For Donation Projects 9o2 0fl < < A 6 5.40 in p42 ?&SKI bA,R f H,! Srz I1) `PAU I. -PL 3�.1 OARiAN VR A TYPEIAIaterlal SIZE Quantity Minimum Unit Cast Actual Unit Cast Total Cost Gravi ty Sewer hl a i n s SSSTRGRAV ._. PVClD•I,P, 8' 57 L.F, $26.001$191.00 1191.06 $10,887.00 PVC 10. PP, 10' L.P. $39,001$208,00 PVC01P. I2' ,L.F, $45.001$225,00 _ Setvlce Laterals: GSSTRLATER PVC /D.I,P, 8" 27 L.F, $50.001$200,00 $50.00 $1 3550.0, 0 Manholes. SSSTRGRAV Precast Cana 2 Each $7,200.04 $7,200-00 $14,400.OQ "Local Force Malns: SSSTRFNILOC , s, O.I.P. 4' L.F. $55,00 D.I.P. 6„ L.F. $60.00 O.I.P. a, L.F. 570.I70 D.LQ, 12' L.F. $90,00 Local Pump Station: PSSTRLQCAL PSEQPLOC Each $42,000.00 Equipment Each $277,000.00 'Regional Force Main: SSSTRFMREG D.I.P. 10' LF, $200,00 D.I;P, 20' L.F. $250.00 NY, 24' L,F. $300.00 'Regional Pump Station: PSSTRREGNL• PSEQPREG ""Structure Each $203.800.00 "'•Equipment Each $307,000.00 Housing & Generator: PLEQPPWRPO 125KW $58,000,00 Valves: 5SMTRFMLOC y,,.• „ , Plu 8' Each $2,230.00 PILg 8' Each $3,000.00 Plug 12" Each $1,760.00 Plug16' Each $5,000.00 i#ond Amount (WASD) 5 S-6 ,Total.P.ro'ect Cast $ $26,637.00 'Regkoul:- Seim pump slalion strung ser ral ma hbanccods Mlh alfiersra3ans Pumping 9a it d Sarco maths bTfealmu f Plant "Local'.• gravy systems. INS stations &small pump slalons fn racal areas, force mains cwryinp kw$ from ISR to mglanel. "'EgolpmenL'• pumA maturlenglne, piy;nQ, vahms, eiebtric3l linos, 6�roikhes• holsi,ect Slrudrue;• swags S s wr egciPmani The back of this document may be used In unite ln.addltional infor S ended, Celtifled by contractor. Slynature: Type, size qua 'ty Inspected by: Signature: Cof t/1— r Date; t: Print: Received by w f3u iness Rep: Slgnaiure: Date: Lli&147 Prin - Company: GP i r` r tE+'Gar Title: Ili Stake of Florida County of Miami -Dade FINAL WAIVER AND RELEME OF LIEN — DEVELOPER , having been duly swum, deposes and says as follows,. To wit 1, I, Arthur Noriega, as City Manager of CITY OF MIAMI, A MUNICIPAL CORPORATION (hereinafter called1he Devoloper'), with the right to executo this final waiver and release of Ilan. 2- For the consideration of amount of ten dollars ($10.00), the Developer hereby waives and releases all liens, Ilan rights, claims or demands of every kind whalsoevar which the Developer now has on the construction of certain donated inprovoments, situated In Mlaml Dade County, Florida, described as: All water & sewer facilities built, constructed and installed to serve Grove Bay Parking Garage — PHASE 2, DW 2016-1416 IDS 2016-573, [DO 22909 located in Section 22-54-41, Miami Dade County, Florida, as shown on Exhibit "A" attached hereto and made a part hereof as more particularly described on Exhibit "B" attached hereto and made a part hereof. I Developer understands that this is a wwhrer and release of lion which the Developer has against the facilities described herein. Developer acknowledges that is has Mean paid in full for al l worts related to the water & sewer facilities described above. 4. Payments in full have heretofore been pard by the Developer to all persons, firms and corporations supplying labor, materials, equipment and supplies, used directly or incirectly by the Developer, or any subcontractor in the prosecution of the work provided on water 6 sewer facillles described herein. 5. There are no claims, demands or liens of any kind attributable to any action taken by the Developer in connection with the work described above which would cause, create or constitute a charge or lien against said Miami -Dade County or the Members of the Board of County Commissioners. 6, The undersigned warrants [hat no assignment of liens or elaimrs, nor the right to perfect a lien, such as the Notice to Owner provision under Section 713.06 (2)(a) of the Florida Statutes, against improvements described or listed heroin, has been or viii be made, and that no claims are outstanding by subcontractors andfor vendors to the Developer. 7. The Developer hereby agrees to indemnify and hold harmless Miami -Dade County and its officers, employees, agents and instrumentalities from arty and all liability, tosses or da magas, including attorneys' fees and costs of defense, which the Miami -Dade County or its officers, employees, agents or instrumentalities my Incur as a result of claims, demands, suits, causes of actions or proceedings of ary kind or nature arising out of, relating to or resulting from the performance of work by the Developer or its errployees, agents, servants, pat*rs, principals, contractors or suboontraclors. Developer hereby agrees to Pay all claims and losses in connection therewith and shad) investigate and defend all claims, suits or actions of any kind or nature in the name of Miami -Dade County, where applicable, including appellate proceedings, and shall pay all costs, judgments, and attorneys fees which may issue therm, 8, Developer hereby waives and releases all claims of any sort as it may have against Miami -Dade County, at law or equity, arising out of the construction of the above water & sewer Improvements_ WITNESSETH: By: Signature Todd B. Hannon, City Clerk STATE OF FLORIDA COUNTY OF MIAMI-DADE CITY OF MIAMI, A MUNICIPAL CORPORATION Signature Arthur Noriega, City Manager The foregoing instrument was acknowledged before me (his day of 20 by Arthur IVorleea, as City Manager, and Todd 6, Hannon, as City Clerk of CITY OF MIAMI, A MUNICIPAL CORPORATION. They are personally known to me or have produced as Wan(iication and didldid not take an oath NOTARY PUBLIC Print name SERIAL NUMBER State of Florida County of Miami -Dade FINAL ifAIVER AND IMT-3AS$ OF LIEN – CONTRACTOR , having been duly swam, deposes and says as folbws. To wit 1.1 am , President of GPE ENGINEERING & GENERAL CONTRACTOR CORP, A Florida Corporation (hereinafter called'the Contractor'), with the right to execute this final waiver and release of lien 2 For tare consideration of arnount of ten dollars ($10.00), the Contractor has agreed to hereby waive, release, and quit claim ail IIons, lion rights, claims or demands of every kind whatsoever which the Contractor now has or may hereinafter hmro agaifrst oras a rosult of tho construction of certain donated improvements. situated in Miami pada County, nonda, described as: All water and sewor facilities bolt, conslnxted and installed to serve Grove Bay Parking Garage –PHASE 2, DW 2016-144 A lis 2016-573. IDN 22W9 located in Section 2254-41, Miarni Glade County, Florida. as shown on Exhibit "A" atlac hod horeto and made a part hered as more particularty described on ExhibR "B" allachecl hereto and made a part hereof. 3. It being the understanding of the Contractor that this is a waiver and release of lien which the Contractor has against the facilities described herein Contractor ackrrowtedges that is has been paid in full for all work related to the water and sewer facilities described above. 4. Payments in full have heretofore been paid by the Contractor to all persons, firms and corporations supplying labor, materials, equipment and supplies, used drect y or indirectly by the Contractor, or any subcontractor In the prosecution of the work prrnnded on water and sewer facilities described herein. S. There are no claims, demands or lions of arty kind attributable to any action taken by the Contractor in connection with the work described above which would cause, create or constitute a charge or lien against said Miami -Dade County or the Members d the Board of County Commissioners. 6. The undersigned warrants that no assgnment of liens or claims, nor the right to perfect a lien, such as the Notice to Own or provision under Section 713.06 (2)(a) of the Florida Statutes, against improvements described or listed herein, has been or will be made, and than no claims are outstanding by subcontractors and/or vendors to the Contractor. 7, The Contractor h>lrehy agrees to irdernnity and hold ham*iss Miami -Dada Canty and its offers, employees, agents and instrumentalities from any and all liability, losses or dor ages. including attorneys' tees and costs of defense, which the Miami -Dade County or its officers, errpiorlrees, agents or instnunentalities may incur as a result of claims, domandis, suits, causes of actions or proceedings of any kind or nature arising out of, relating to or resulting from the performance of work by the Contractor or its employees, agents, servants, partners, principals, contractors or subcoritradors. Contractor hereby agrees to pay all claims and losses in connection therewith and shall investigate and defend all claims, suits or actions d arry kind or nature in the name of Karn -Dada County, where applicable, iricluding appellate proceedings, and shall pay all oasts, judgments, and attomey's fees which may issue therem- 8. Contractor hereby wraiues and releases all claims of any sort as it may have against Miami -Dada County, at law or equity, arising out of the construction of the above water arid sewer improvements. WITNESSETH: Signature Print name Signature Print name STATE OF FLORIDA COUNTY OF MIAMI-DADE By: GPI: ENGINEERING & GENERAL CONTRACTOR CORP, A Florida Corporation ;fir,"'T — - 11 '•.T 12L7711117 Mu_ The foregoing instrument was acknowledged before me this day of . 20— by -- as President, of GPE ENGINEERING & GENERAL CONTRACTOR CORP, INC., A Florida Corporation. FWSha is personally known to me or have produced as identification and did/did not take an oath. NOTARY Pt1BUC Print name SERIAL WARRANTY This Warranty hereby made and entered into this day of 20 , by GPE ENGINEERING & GENERAL CONTRACTOR CORP, A FLORIDA CORPORATION, whose mailing address is: 13117 NW 107TH AVE, UNIT 1, HIALEAR GARDENS, FL 33018, who does hereby warrant to MIAMI -DARE COUNTY ("COUNTY") and the MIAMI -DADS WATER AND SEWER DEPARTMENT ("DEPARTMENT") the property described below to be free from defects in materials and workmanship for a period of one (1) year from the date hereof: All water and sewer facilities built and constructed to serve Grove Bay Parking Garage - PHASE 2, DW 2016-144 & DS 2016-573, ID# 22909 located in Section 22-54- 41, Miami -Dade County, Florida, as shown on Exhibit "' A" attached hereto and made a part hereof and as more particularly described on Exhibit "B" attached hereto and made a part hereof. The undersigned shall at no cost to the COUNTY and DEPARTMENT, repair, replace or otherwise remedy such defects to the full and complete satisfaction of the COUNTY and the DEPARTMENT. IN WITNESS WHEREOF, the undersigned has executed this warranty by its duly authorized officers or representatives on the day and year above written. WITNESSETH: GPE ENGINEERING & GENERAL CONTRACTOR CORP, A FLORIDA CORPORATION Signature By: Print name Sianature Print name Signature of President Print name: Tax Folio Number: 01.4122-002-0010 Agmt ID: 22909 GRANT OF EASEMENT — PHASE 2 THIS INDENTURE, made this day of 20----, between CITY OF MIAMI, A MUNICIPAL CORPORATION, whose mailing address is: 444 SW 2"d AVE, 101h FLOOR, MIAMI, FL 33130, hereinafter called GRANTOR, and MIAMI-DADE COUNTY, a political subdivision of the State of Florida, whose mailing address is: c/o Miami -Dade Water and Sewer Department, P.C. Box 330316, Miami, Florida 33233-0316, hereinafter called GRANTEE: WITNESSETH THAT, the GRANTOR, for and in consideration of the sum of TEN DOLLARS ($10,00) and other good and valuable considerations, the receipt of which is hereby acknowledged by the GRANTOR, has granted and does hereby grant, to the GRANTEE, its successors and assigns, forever, the right, privilege and easement to construct, reconstruct, lay, install, operate, maintain, relocate, repair, replace, improve, remove and inspect water transmission and distribution facilities and all appurtenances thereto, including but not limited to. fire hydrants, and/or sewage transmission and collection facilities and all appurtenant equipment, which right, privilege and easement shall include the right to remove or demolish, with no obligation to repair or replace same, any obstructions placed on the easement, including pavers, or that may extend up to twenty-five (25) feet vertically above the finished grade over the easement, as may be necessary to carry out any right granted herein. This right, privilege and easement also provides GRANTEE with full and unlimited right of ingress thereto and egress there from on the property of the GRANTOR described as follows, to wit: See Exhibit "A" attached hereto and made a part hereat THE GRANTOR does hereby fully warrant that it has good title to the above-described property and that it has full power and authority to grant this easement. IN WITNESS WHEREOF, the GRANTOR by its proper officials has hereunto set its hands and seals the year and day first above written_ ATTEST - Signature Todd B. Hannan, City Cleric STATE OF FLORIDA COUNTY OF DADE The foregoing instrument was acknowledged before me this CITY OF MIAMI, A MUNICIPAL CORPORATION OF THE STATE OF FLORIDA By: Signature Arthur Norlega, City Manager day of 20__ by Arthur Noriega, as City Manager, and Todd B. Hannon, as City Cterk, of CITY OF MIAMI, A MUNICIPAL CORPORATION OF THE STATE OF FLORIDA, on behalf of the corporation. He/She/They is/are personally known to me or havethaven't haslhasn`t produced NOTARY PUBLIC. SIGNATURE 11:717e111 1_1.[14 as identification and did/did not take an oath. MY COMMISSION EXPIRES This instrument prepared by Utility Development Division Miami -Dade Water and Sewer Departrnew 3575 S. LeJeune Road Miami, Florida 33146 "A" 1 of 1 EXHIBIT "A" N GROVE BAY PARKING GARAGE MIAMI-DADE WATER EASEMENT FOLIO # 01-4122-002-0010 DW -2016-144 AGREEMENT ID# 229109 SCALE: I-=3Do' SECTION 22, TOWNSHIP 54 SOUTH, RANGE 41 EAST MIAMI-DADE COUNTY, FLORIDA EASEMENT SITE LOCATION LEGEND: q CENTER LINE I °MONUMENT LINE LL 'LEASE LINE ROW -RIGHT WAY PB -PLAT BOOK PG -PAGE POC = POINT OF COMMENCE POB _ POINT OF BEGBNING POT = POINT OF TERMINATION LOCATION MAP SCALE: 1" = 300' NOTES: I. ALL. DISTANCES AS SHOWN ARE BASED ON THE US SURVEY FOOT. 2. THE MINIMUM VERTICAL CLEARANCE OF THIS EASEMENT 15 TWENTY FIVE (25) FEET ABOVE GRA]E I THESE EASEMENT STRIPS FROM A CLOSED GEOMETRIC FIGURE. 4. THIS SKETCH AND LEGAL DESCRIPTION IS NOTA BOUNDARY SURVEY. S. BEARINGS ARE BASED ON AN ASSUMED MERIOIAN, WHERE THE CITY MONUMENT LINES STARTING ON SW. 27TH AVENUE ALONG SOUTH BAY SHORE DRIVE OF TRACT W OF DINNER KEY, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 34, PAGE 2 OF PUBLIC RECORDS OF AUAMWADE COUNTY. FLORIDA, BEARS NORTH 38 lnl' EAST. 5. NO TITLE SEARCH HAS BEEN CONDUCTED BY NOR WAS A TITLE REPORT PROVIDED TO THE SURVEYOR, 7. THERE MAY BE EASEMENTS, RIGHTS OF WAY ANDIOR OTHER ENCUMBRANCES AFFECTING THE EASEMENT AREA NOT DISCLOSED HEREON THAT A TITLE REPORT WOULD EVIDENCE. 8. THE INTEND OF THIS EASEMENT IS TO ENCOMPASS THE RECENTLY INSTALLED WATER SERVICES. THIS EXHIBIT CONSISTS OF 3 PAGES AND EACH PAGE SHALL NOT BE CONSIDERED FULL, VALID AND COMPLETE UNLESS ATTACHED TO THE OTHERS TOGETHER WITH THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA UCENSED SURVEYOR AND MAPPER ON PAGE I OF 3, ANY ADDITIONS OR DELETIONS TO THE DESCRIPTION AND ACCOMPANYING SKETCH BY OTHER THAN THE SIGNING PARTY OR PARTIES IS PROHIBITED WITHOUT WRITTEN CONSENT OF THE SIGNING PARTY OR PARTIES. SURVEYOR'S CERTIFICATION: CERTIFIED TO MIAMI DADE COUNTY [WASO] THIS IS TO CERTIFY THAT THIS LEGAL DESCRIPTION AND THE ACCOMPANYING SKETCH WAS PREPARED UNDER MY DIRECTION AND THAT IN MY PROFESSIONAL OPINION IS TRUE AND CORRECT. I FURTHER CERTIFY THAT THIS SKETCH TO AOCOMPANY LEGAL DESCRIPTION MEETS THE INTENT OF THE APPLICABLE PROVISIONS OF THE STANDARDS OF PRACTICE, ADOPTED BY THE BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS. PURSUANT TO CHAPTER 472.027 FLORIDA STATUSES, AS SET FORTH W CHAPTER.5A-7 7, FLORIDA ADMINISTRATIVE COBE. COUNTYWIDE LAND SURVEYORS, INC. LB 4680 BATE 024m JC`3EPH I^ MAFTTIN P%04W M9GRX0wNAL rJNEroR + MINI'M elrAIM Cr I" LMIPA Nm I RATS > GROVE BAY �, DOW. GROVE 02-14-2020 SHEET 7 WV= WASUcow. 3 WASRC06W. C LAND SURE UI R SURVEYORS,-PANEINC. PARKING GARAGE SCALE AS SHAWN � �,� r� LAND WDESURWYORS -PLANNERS J 1533! sm, 14" 51AL'PT � FL 13190 3500 PANAMERICAN DRIVE DW 2016r144 MIAMI, FL 33133 GROVE BAY PARKING GARAGE MIAMI-DADE WATER EASEMENT FOLIO # 01-4122-002-0010 DW -2015-144 AGREEMENT ID# 22909 SECTION 22, TOWNSHIP 54 SOUTH, RANGE 41 EAST MIAMI-DADE COUNTY, FLORIDA A PORTION OF TRACT "A" OF A DINNER KEY, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 34, PAGE 2 OF PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA AND MORE PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCE AT THE INTERSECTION OF THE CITY MONUMENT LINES OF SW. 27TH AVENUE WITH SOUTH BAYSHORE DRIVE AS SHOWN ON SAID PLAT OF DINNER KEY, THENCE RUN NORTH 38 DEGREES 10 MINUTES 31 SECONDS EAST, ALONG THE MONUMENT LINE OF SAID BAYSHORE DRIVE, FOR A DISTANCE OF 532.12 FEET TO A POINT; THENCE RUN SOUTH 44 DEGREES 34 MINUTES 37 SECONDS EAST, ALONG THE NORTHWESTERLY EXTENSION OF THE HISTORIC RIGHT-OF-WAY LINE AS SHOWN ON THAT BOUNDARY SURVEY "DINNER KEY CONVENTION CENTER'S ADJACENT PARKING LOT" PREPARED BY GOLD COAST ENGINEERING CONSULTANTS INC. DATED SEPTEMBER 30, 1999 (PER LEGAL PROVIDED), FOR A DISTANCE OF 77.52 FEET TO A POINT; THENCE CONTINUE SOUTH 44 DEGREES 34 MINUTES 37 SECONDS EAST, FOR A DISTANCE OF 394-43 FEET TO A POINT; THENCE RUN NORTH 45 DEGREES 25 MINUTES 23 SECONDS EAST, FOR A DISTANCE OF 154.12 FEET TO A POINT, ALSO THE WESTERLY LINE OF THE EXISTING 1S WIDE WASD EASEMENT; THENCE RUN NORTH 15 DEGREES 08 MINUTES 57 SECONDS EAST, FOR A DISTANCE OF 32.55 FEET TO THE POINT OF BEGINNING OF THE FOLLOWING DESCRIBED WASD EASEMENT; THENCE CONTINUE NORTH 15 DEGREES 08 MINUTES S7 SECONDS EAST, FOR A DISTANCE OF 27.87 FEET TO A POINT; THENCE RUN NORTH 74 DEGREES 51 MINUTES 03 SECONDS WEST, FOR A DISTANCE OF 9.00 FEET TO A POINT; THENCE RUN SOUTH 15 DEGREES 08 MINUTES 57 SECONDS WEST, FOR A DISTANCE OF 27.87 FEET TO A POINT; THENCE RUN SOUTH 74 DEGREES 51 MINUTES 03 SECONDS EAST, FOR A DISTANCE OF 9.00 FEET TO THE POINT OF BEGINNING, ALSO TFiE POINT OF TERMINATION OF THE WASD EASEMENT. THE SIDE LINES OF THESE EASEMENTS ARE TO BE SHORTENED OR LENGTHENED , SO AS TO INTERSECT THE RELEVANT LOT, BLOCK, TRACT, BUILDING OR EASEMENT LINES. SAID PORTION OF LAND CONTAINING 251 SQUARE FEET OR 0.0058 ACRES MORE OR LESS; LYING AND BEING IN SECTION 22, TOWNSHIP 54 SOUTH, RANGE 41 EAST, CITY OF MIAMI, MIAMI-DADE. THIS EXHIBIT CONSISTS OF 3 PAGES AND EACH PAGE SHALL NOT BE CONSIDERED FULL. VALID AND COMPLETE UNLESS ATTACHED TO THE OTHERS TGGETHER WITH THE SIGNATURE AND THE ORIGBNAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER ON PAGE I OF 3, ANY ADDITIONS OR DELETIONS TO THE DESCRIPTION AND ACCOMPANYING SKETCH BY OTHER THAN THE SIGNING PARTY OR PARTIES IS PROHIBITED WITHOUT WRJTTEN CONSENT OF THE SIGNING PARTY OR PARTIES. COUNTY—WADE LA 0 SURVtYORS. INC. LAND SURVEYORS — PLANNERS i53s6 S.w. 1WIh SWEET MI we, R 3719E M w3.772.07$E GROVE BAY PARKING GARAGE 3500 PANAMERICAN DRIVE MIAMI, FL 33133 DATE: 02-14-2020 SHEET 2 of 3 %�\ GROVE BAY PARKING GARAGE MIAMI -DACE WATER EASEMENT FOLIO # 01-4122-002-0014 100 0 50 100 DW -2016-144 AGREEMENT ID# 22909 SECTION 22, TOWNSHIP 54 SOUTH, RANGE 41 EAST GRAPHIC SCALE(IN FEET) MIAMI-DADE COUNTY, FLORIDA SCALE: V= 109 fir. I 23' 27'- a ..� lz a °1 ` + 1, I , Q � I 17' 5O' 2 1 544"34'37"E 77.62' � � c POC fAlb CITY OF BMAUI RASS !i AIdNUA1TC��11/4�" 8RA55 "k\ PIPE IN CONCRETE SQ(IARE wl L7ETAIL 'A' � ` Por TRACT 'A' DINNER KEY N15'08'57"E' P6 34, PG 2 32.55' WE DffENShON Or MTORIC N45'25'23"E SOPOWB 154.12'HWNVTMF AS ` SURVEY "DINNER KEY +O CDNVEN770M CENIERS AD.WCENT PARKING LPD` p 544'34'37"E 394.43' --- — - -- --- PANAMERICAN Dr THIS-------- THIS EXHIBIT CONSISTS OF 3 PAGES AND EACH PACE SHALL NOT BE CONSIDERED FULL. VALID AND COMPLETE UNLESS ATTACHED TO THE OTHERS TOGETHER WITH THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER ON PAGE 1 OF 3, ANY ADDITIONS OR DELETIONS TO THE DESCRIPTION AND ACCOMPANYING SKETCH BY OTHER THAN THE SIGNING PARTY OR PARTIES IS PROHIBITED WITHOUT WRITTEN CONSENT OF THE SIGNING PARTY OR PARTIES N74'51'03'W '� t1' r•`y��\S� gip' 9.00' �N 1 N15'08'57"E 27.87' � WATER In 515'08'57" W 27.87' rN15'08'57"E ++ 32.75" I S74'51'03"E . `( 9.00' 'i 4 ❑ETAIL A A' SCALE -1' 20' _Poe POT No. DATE REVISION 1 y1NM WAM COM. GROVE BAY DATE: 02-14-2020 SHEET 2 M1020 WAMMUff- .... '. COUNTY—NDE y D SURVEYORS, TNG PARKING GARAGE SCALE AS SHOWN r� r� YeM?20 WAfpLl?. LAND SURVEYORS — PLANNERS JJ J '�N S.WU1. FL oN $' 3500 FANAMERICAN ©RIVE MALI, f2. Il3196 DW 2011-144 PH: 7aa.rizo7es MIAMI, FL 33133 15' WASP E4stwrmr EXIST. 12' HpSb `+ fASEAfEM + L7ETAIL 'A' � ` Por TRACT 'A' DINNER KEY N15'08'57"E' P6 34, PG 2 32.55' WE DffENShON Or MTORIC N45'25'23"E SOPOWB 154.12'HWNVTMF AS ` SURVEY "DINNER KEY +O CDNVEN770M CENIERS AD.WCENT PARKING LPD` p 544'34'37"E 394.43' --- — - -- --- PANAMERICAN Dr THIS-------- THIS EXHIBIT CONSISTS OF 3 PAGES AND EACH PACE SHALL NOT BE CONSIDERED FULL. VALID AND COMPLETE UNLESS ATTACHED TO THE OTHERS TOGETHER WITH THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER ON PAGE 1 OF 3, ANY ADDITIONS OR DELETIONS TO THE DESCRIPTION AND ACCOMPANYING SKETCH BY OTHER THAN THE SIGNING PARTY OR PARTIES IS PROHIBITED WITHOUT WRITTEN CONSENT OF THE SIGNING PARTY OR PARTIES N74'51'03'W '� t1' r•`y��\S� gip' 9.00' �N 1 N15'08'57"E 27.87' � WATER In 515'08'57" W 27.87' rN15'08'57"E ++ 32.75" I S74'51'03"E . `( 9.00' 'i 4 ❑ETAIL A A' SCALE -1' 20' _Poe POT No. DATE REVISION 1 y1NM WAM COM. GROVE BAY DATE: 02-14-2020 SHEET 2 M1020 WAMMUff- .... '. COUNTY—NDE y D SURVEYORS, TNG PARKING GARAGE SCALE AS SHOWN r� r� YeM?20 WAfpLl?. LAND SURVEYORS — PLANNERS JJ J '�N S.WU1. FL oN $' 3500 FANAMERICAN ©RIVE MALI, f2. Il3196 DW 2011-144 PH: 7aa.rizo7es MIAMI, FL 33133 'NOTE: The Opinion must cover the time period to within 34 days prior to submittal of signed water and sewer agreements or an assignment. FOR WARRANTY DEEDS, EASEMENTS, COVENANTS AND UNITIES OF TITLE, THE OPINION MUST COVER THE TIME PERIOD THROUGH THE DATE OF EXECUTION OF THE DEED, EASEMENT, COVENANTOR UNITY. The opinion for all LLC agreements and N.V. property owner corporations must state that the person(s) signing the agreement or legal document has the legal power and authority to sign on behalf of and bind the entity. MIAMI-DADE COUNTY MIAMI-DADE WATER AND SEWER DEPARTMENT OPINION OF TITLE To: MIAMI DADE COUNTY, a political subdivision of the State of Florida. With the understanding that this opinion of title is furnished to MIAMI DADE COUNTY, FLORIDA, as an inducement for execution of an agreement covering the real property hereinafter described or for acceptance of a warranty deed, easement, covenant or unity of title, as applicable, it is hereby certified that I (we) have examined the complete Abstract of Title or Title Policy Number issued by dated and the following; covering the period from the BEGINNING to A.D. 20 at inclusive, of the following described real property: (Legal description as it appears in agreement or legal document) Basing my (our) opinion an said complete abstract or title policy covering said period I (we) am (are) of the opinion that on the last mentioned date the fee simple title to the above described real property was vested in: Subject to the following liens, encumbrances and other exceptions: GENERAL EXCEPTIONS L All taxes for the year in which this opinion is rendered, unless noted below that such taxes have been paid. 2. Rights of persons other than the above owners who are in possession. 3. facts that would be disclosed upon accurate survey. 4. Any unrecorded labor, mechanics or material men's fens. 5. Zoning and other restrictions imposed by governmental authority SPECIAL EXCEPTIONS No LJ Yes (please disclose) F1 None of the exceptions listed above will restrict the use of the property for the purposes set forth in the water and sewer agreement, assignment, warranty deed, easement, covenant and unity of title, as applicable. 1, the undersigned, further certify that I am an attarney-at-law duly admitted to practice law in the State of Florida and am a member in good standing of the Florida Bar. SIGNATURE ADDRESS Respectfully submitted this PRINTED NAME day of FLORIDA BAR NUMBER PHONE NUMBER MAINTENANCE BOND KNOW ALL MEN BY THESE PRESENTS, that DEVELOPER OR CONTRACTOR as Principal (s) (hereinafter called PRINCIPAL), and SURETY COMPANY a corporation with its principal place of business in SURETY COMPANY'S ADDRESS , as Surety (hereinafter called SURETY) are held and firmly bound unto Miami -Dade County, a political subdivision of the State of Florida, (hereinafter called OBLIGEE), in the full and just sum of Dollars to the payment of which, well and truly to be made, the PRINCIPAL and SURETY hereby bind themselves, their successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Obligee and DEVELOPER'S NAME have entered into an Agreement dated AGREEMENT EXECUTION DATE , for the installation of certain water and/or sewer facilities generally described as AGREEMENT NAME AND ID#, DW and DS NUMBERS , and WHEREAS, said facilities have been completed by the said PRINCIPAL and accepted by the said OBLIGEE, said acceptance subject to the furnishing by the PRINCIPAL of a Maintenance Bond in the sum herein set forth to hold the OBLIGEE harmless from and against all expenses incurred in the replacement of any inferior materials or faulty workmanship contained in the aforementioned facilities. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH that CONTRACTOR'S NAME shall in all respects promptly and faithfully perform and comply with the terms and conditions of said Agreement relative to the representations and warranties as to the condition of the materials and workmanship and shall further indemnify and hold harmless said OBLIGEE from and against all expenses incurred in the replacement of any inferior materials or faulty workmanship contained in the aforementioned facilities for a year period commencing on the NOTICE OF COMPLETION DATE OR AFTER day of then this obligation shall be voided, otherwise to remain in full force and effect. IN WITNESS WHEREOF, Principal has caused this instrument to be executed by its officials, duly authorized, this day of ATTEST: 0 Secretary PRINCIPAL 0 By: By:_ (Signature of Resident Florida Agent) Title: (Corporate Name) President SURETY (Corporate Name) POWER OF ATTORNEY FOR RESIDENT FLORIDA AGENT MUST BE ATTACHED. Form WW9 1 Request for Taxpayer (Rev,0ctober2018) identification Number and Certification Innllemmal Revenue Service ry ■ Go to www.1►s.9ov/FarrnW9 for irlstructlons and the latest Information. 1 Name (as shown on your income fax return). Name is required on this tine; do not leave thin line blank 2 Business namerd wegarded entity name, If differierid from above Give Form to the requester, Do not send to the I RS. "' 3 Check nate hose for federal lou clesslflcatkxl rA the n whose name erriered on Ilne 1. Check tm ora of ilii �' aWPr'op R IY 4 Exemptions codes apply only to fdlovnng seven boxes. cerlaln eraifies, not iridivduats; we it Instructions on page 3) 7� © Iridividual/sole proprietor or ❑ C Corporation ❑ S Corpomlion ❑ partnership ❑ Tremt/astate single -member LLC Exempt payee code (it any) ❑ Limited liability company. Enter the tax classification (C=C corporation, S_ -S. corporation, P=partnership)! Note: Check the appropriate box in the line above for the tax classification of the single -member owner. bo riot check Fxomption from FATCA reporting LLC if the LLC is classified as a single -member LLC That is disregarded from the owner unless the owner of the LLC is code (if any) another LLC that is not disregarded from the owner for U.S. federal tax purposes. ("herwise, a single -member LLC that is disregarded from the owner should check the appropriate box for the tax classif ication of its owner. Other (number, street, and apt or suite ria.) See Instructions - 6 Qty, state, and ZIP code 7 List account number(s) here (optlonal) KIMM Taxpayer Identification Number (TIM { m.emur6 ma6rYed aunHrs ma u.s r name and address (optional) Enter- your TI in the appropriate box, The TIN provided must match the name given on line 1 to avoid Speial Security numh4r backup withholding. For individuals, this is generally your social security number (SSN). However, for a - _ L resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a 771V, later, or Note; If the account is in more than one name, see the instructions for line 1. Also see What Name and I Emptor ideriMalion number Number To Give the Requester for guidelines an whose number to enter. 1—F-1 t:eritllcetion Under penalties of perjury, I certify that: 1. The number shown on this foam is my correct taxpayer identification number (or I am waiting fora number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U,S. citizen or other U.S. person (defined below); and 4. The FATCA oode(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certifwation instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax retum. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends. you are not required to sign the certification, but you must provide your correct TIN. See tate instructions for Part 11, later. 31rgi1 I Signature of Here I u.s. person ■ Date ■ General instructions Section references are to the Intemai Revenue Code unless otherwise noted. Future developments. For the latest Information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to wwwJmgov1FofmW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an infomfation return with the IRS must obtain your correct taxpayer identftition number (TIN) which may be your social security number (SSN), individual taxpayer identification number OTIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of infom+ation returns include, but are not limited to, the following, • Form 1099 -INT (interest eamed or paid) • Form 1099 -DIV (dividends, including those from stacks or mutual funds) • Form 1499-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-8 (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-5 (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 10%-T(tuition) • Form 1499-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (ncluding a resident alien), to provide your correct TiN. ff your do not retum Form W-9 to the requester with a TIN, you might be subject to backup wfthhokkng. See What is backup withholding, ?afer. Cat. Na. 1031X Form W-9 (Rev. 10-20181 Water and Sewer M A NEW ACCOUNT WORK FORINT PO cox 33016 Please complete highlighted areas only Miami, FL 33233-0315 mlamldadr„{m SP CREATE DATE: `i' 785-268-5350 Customer None: SS # or Federal Tax ID#; E -Mail Address: Daytime phone number(s): C 1 0 2 Mailing Address: Cky; State: Zjp; PLEASE NCITE: Customers) requesting meters will be responsible for all bills until a Disconnect or Transfer of Services) is Requested. By signing this application you are acknowledging that the following meter box conditions have been checked. Floating Meter has been removed. Tail piece and spacer has been Installed, consumer line has been connected to the tail peace, concrete slab was installed according to WASD standards, meter box and slab must be clear of debris and water, meter box and/or sidewalk must not be cracked, suitable building numbers have been affixed to the building, and street sign matching address has been Installed according to Sec 33-149 (a) & Sec 28-15 (4) of the Miami -Dade County Code. For additional design construction standards details information, please visit: Part IV - MDWASD Standard Details at www.rniamidade.gov/water/desigr-mnstructlor"tandards.asp#pnrt4 Name and Title of Person Authorizing Application: SIGNATURE: DATE: #of Units/ SQ FT: Premise Address: Folio #: CCB Account #: MTR Location: GPD: SP Size: Mtr Size: LAT: BLK: Customer ID/Invoice No. OP Area: Municipality: I Premise Type: Subdivision: Zip Cade; Quarterly ❑ Monthly Q W&s ❑ water Meter installation Fees: wonly ❑ [J Yes ❑ No Premise case (Notes) (s): Premise Case ID: la NEEDS FOU0`S ❑NEEDS MTR LOC AT MTR SET REQ EINEEDS SS# or FEDERAL TAX ID VF Number Agreement# Conveyance Required: ❑ Yes ❑ No "G' Restriction 11 Yes ® No + `L' Region ❑ Yes ❑ No ER water: NBR NAME: Processed Date: NBRS€pm tore: Must provide wASD at least two schedule dates not sooner than 5 days ER Sewer: Supervisor Name: Approved pate: Superviw Swu Lure: 1" choice Set M eter schedule date: 2nd choice Set Meter schedule date: ❑ Checked Revised Building Plans (see attached) NBP NAME; DATE. RECEIVED: NBP Signature: APPROVED SCANNED BY: DATE: BY: Rev. 1/26/2017 GG/LD/EM/DR/SPA