HomeMy WebLinkAboutBack-Up DocumentMIAM
CO NTY
maairtic.sm.
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 ID# 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 if there is an error or a revision needed_
After depositing any conveyance documentation into the Conveyance box in the Lejeune office iobbv. send an email_to our
Conveyance Unit Distribution List, at WASD-Conveyanceemlamidade.gov, to notify us that you have dropped off items. This
is very important 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_
#
Type of Document
Requested to
Received Date
Comments
1
Absolute Rill of Sale
Developer / Owner
2
Final Waiver and Release of
Lien - Developer
Developer / Owner
3
Final Waiver and Release of
Lien - Contractor
Contractor
4
Warranty Letter
Contractor
5
Bill of Materials / Cost
Breakdown
Contractor
4/20/2020
6
Grant of Easement
Land Owner
7
Easement- Legal Description
Developer 1 Owner
4/20/2020
8
Opinion of Title
Owner's Attorney
9
Maintenance Bond 1 Letter of
Credit
Contractor
10
W-9
Developer 1 Owner
11
Recording Fees - Easement
Developer / Owner
Please provide a one (1) year Maintenance Bond OR Letter of Credit, to cover the cost of the facilities installed, in the amount al
twenty-five percent (25%) for water main facilities, fifty percent (50%) 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 Opinion 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 "WASD " Or, after requesting and receiving an
invoice from the Conveyance Unit, you may pay online at:
http_I/www_miamidade_govfwater/construction -development-payments. asp
The table below details the total fixed amount to be paid.
Fixed Fee Item Price (S)
Recording Fee - lst Page Only
10
Total Quantity Total Fees (Si
1.00
10.00
Recording Fee - Per Page after 1st
8.5
3.00
25.50
Page 1 of 2
Total Fixed Fee
$ 35.50
The approved building plans shall be required for final review before the meter(s) are scheduled. The New Account Work Form,
included in the package, can be completed and submitted any Time, 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
NewBusinessSucvlistOmiamidade.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 corporation must have the corporation seal affixed, and please take particular note 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
receiving all required items, including 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 sidess Conveyance Unit
0an_DelMazoCa7miamidade.gov
Carolina. 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 A:
ABSOLUTE BILL OF SALE
22909
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 & 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
of , 20 _
ATTEST:
By:
CITY OF M I , A MUNICIPAL
CORPORATION OF THE STATE OF
FLORIDA
Signature Signature
Todd B. Hannon, City Clerk Arthur Noriega, City Manager
day
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
The foregoing instrument was acknowledged before me this day of
, 20 by 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 as
identification and did/did not take an oath.
NOTARY PUBLIC
PRINT NAME
SERIAL NUMBER
6' DIP MANIFOLD
6' GATE VALVE
6'XI2• DIP TEE
6" GATE VALVE
6'XI2' DIP TEE
6' GATE VALVE
6'XI2' DIP TEE
THIS IS NOT AN ASBUILT
THIS IS NOT A SURVEY
MIAMI-DADE COUNTY
SEC. 22
TOWNSHIP. 54
RANGE. 41
2' V. SERv!EC
2' RPDP
2' W. SERVICE
2' RP BP
2' V. SERVICE
2' RPDP
2" V. SERVICE
1' RP BP
RPDP
l• W. SERVICE
I' W. SERVICE
1
I
FIRE HYDRANT
teNN 12'GA It VALVE
12'X12' DIP TEE
i
N
32 LE -12' DIP W.R.
12' - 45' DIP DENO
12' - 45' DIP BEND
12' TAPPING VALVE
12'X24• TAPPING SLEEVE
Q3
Jfi
SCALE N.7.S,
1
LEGEND
WATER MAIN - ABANDONED OR REMOVED ' ' ' 1/2174/.
WATER MAIN - EXISTING
WATER MAIN - NEW
GATE VALVE / BUTTERFLY VALVE - EXISTING
GATE VALVE / BUTTERFLY VALVE - NEW
TAPPING SLEEVE & VALVE
SINGLE SERVICE
DUAL SERVICE
2" SERVICE
4" SERVICE
TURBINE METER
FIRE HYDRANT ASSEMBLY ' ' ' ' ' ' , •
FIRELINE
WATER 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.
11107/2019
AGREEMENT ID # ' 22909
DW 2016-144
SHEET 1 OF 1
htlAMF•FADE
Agreement DM
Project Name:
Project Location:
Contractor:
Inspector:
EXHIBIT B
Mlaml-Dade Water and Bower Deportment
Water 13111 of Materials /Cost Breakdown For Donation Protects
c2909 w) t i6 — CeIZI
l e 11
435CX7 ?cin evAc_ctTn r, Nli e mfi PLll 331.3
C, P tr E ng Ya g Yi r-t cJ 4 7er e l
T)c 'rjg In \t of
TYPEJMaterlal SIZE
Quantity
Minimum Unit Cast Actual Unit Cost
Total Cost
" Local Water Main InclIFIttings
D.I.P.
6'
L,F.
$60.00
DISTRIBUTN
D.I.P.
8'
L.F.
$70.00
DIP.
12"
of o& k L.F.
$80.00
4 i3 D. co
.1.1'2)1 043Q. CO
D.LP.
16"
L.F.
$130,00
"4Regional Water Main incliFittings
DIS T RIBUTN
A.I.P.
24"
L.F.
$140,00
—
D.I.P.
38'
L.F.
$210,00
Valves:
DISTRJBUTN
Gate/Tapping
s'
Each
3600.00
Gale/Tapping
B'
Each
$920.00
Gate/Tapping
12'
a Each
$2,300.00
.al �. t�
1r bC�].
Gale/Tapping
16'
Each
$5,100.00
WaterSaavtce:
DISTRSVCS
Single
1'
.2, Each
$1,800.00
. I 0C1•
316CO.00
Dual
1'
Each
$1,900.00
2' Service
2'
. 5" Each
$2,300.OD
4, , 3[O. 00
j I .500. CC
4" Service
4'
Each
$3,300.OD
Turbo
4"
Each
$11,500.00
Turbo
6`
Each
$11,800.00
Turbo
8'
Each
$12,100.00
Turbo
10'
Each
$12,400.00
Flreline Lateral:
DISTRSVCS
D.I.P.
4'
Each
$3,200.00
DIP.
6"
..a.., Each
$3,500.00
, 3t 5oO. 00
4 31.6no, cc
DIP.
8"
Each
$5,300.00
Fire Hydrant:
DISTRI YDR
DIP.
6"
i Each
33,900.00
5 3ic1Co.. co
$3, 9m. vp
Bond Amount (IMAM) $ ill i _ Total Project Cost $4 eiS 1.801C0
'Restoration and labor must be included In unit costs
"Regional :• WM 24-incites or greater Local:. WM less than 24-Inches
The back of this document may be used to write in additional info iasa ttn if needed.
Certified by contractor:
Type, size
Date: Y 2.
4
anlily Inspected by:
Received by ew Bu mess Rep:
Date:
Signature:
Signature:
Print:
Signatt r
Prints.
K •". M.13
Or
ncrip,A
tA
de AA
Company: eK jr i1Ett 5SR.icka tt6&✓ • CCSATG CaZP.
itle: P
MIAMI-DADE COUNTY
SEC. 22
TOWNSHIP. 54
RANGE. 41
�r
! V
N.T.S.
AN ASBUILT
A SURVEY
Sri
J (\ /,/SCM.E:
/ f�//
-STORY
PARK/Alp,
G GA
RAGE $UILD/NG
S
rsi�
\
�'SP
\ e N.,- p
\ �'• \cam(,)
7 ;Jr O.
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THIS IS NOT
THIS IS NOT
LEGEND
GRAVITY MAIN
GRAVITY MAIN
MANHOLE - EXISTING
MANHOLE - NEW
SEWER LATERAL
GATE VALVE 1
GATE VALVE)
1 FORCE MAIN - EXISTING
TAPPING SLEEVE & VALVE
CHECK VALVE BURIED
CHECK VALVE IN MANHOLE
PUMP STATION
GENERATOR HOUSING
GENERATOR
GRAVIYMA1NIFORCEMAIN-ABANUONEOORREMOVED •
H it
N
0
0
//,
1 FORCE MAIN - NEW • • • • •
0
•
PLUG VALVE - EXISTING pQ
PLUG VALVE - NEW • • 0041
In
,,off
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.
DATE: 11/07/2019 AGREEMENT ID # : 22909 I DS 2016-573
)
MIAMI I: ADE
'k:: ilY a3�f r_tr K:f1: cr FM.? �lr
Agreement iDft•
Project Name:
Project Location:
Contractor:
Inspector:
EXHIBIT B
Miami -Dade Water and Sewer Department
Wastewater Bill of Materials /Cost Breakdown For Donation Projects
ce_4290, • &16 — 540
GvarAt P ' ?ARK' rtit b,krIA6 - (PHASE I1)
a'co.`-P 414EsR1h0 :DR:. Nitgrn.49L, 3 .135
TYPEIMaterlal SIZE
Quantity
Minimum Unit Cost Actual Unit Coat
Total Cost
Gravity Sewer I..ains
SSSTRGRAV
PVC1D,I,P,
8"
57
L.F.
$20.00/$191.00
$191.00
$10,887.00 '
PVC /W,P,
10'
L.P.
$38,00 / $208.00
1
PVC/D.I..P.
12'
I
.
; ,L.F,
$45.00 f $225,00
_
Setvica Laterals:
SSSTRLATER
PVC IO.I,P,
8"
27
L,F,
$50.00 f $200.00
$50.00
$1 35�0.00
Manholes:
SSSTRGRAV
Precast Cana
2
Each
$7,200.00
$7,200.00
$14,400.0C
"Local Force Mains:
SSSTRFMkQC , 1 „
s , .
O.I.P.
4'
L.F.
$55.00
0.I.P,
6'
L.F.
$50.00
Q.I.P.
8"
L.F.
$70.130
D,I.P,
12'
L.F.
$90.00
"Local Pump Station:
PSSTRLOCAL
PSEQPLOC
Structure
Each
$42,000.00
Equipment
Each
$277,000.00
'Regional Force Main:
SSSTRFMREG
D.I.P.
10'
L,F,
$200,00
D.I,P,
20'
L,F,
$260.00
D.I.P.
24'
L,F.
$300.00
'Regional Pump Station:
PSSTFtREGIi
PSEQPREG
'*'Structure
Each
$203,800,00
'"'Equipment
Each
$307,000.00
Housing & Generator:
PLEQPPWRPD
125KW
$58,000.00
Valves:
5SSTRFtv1LOC
Plug
8'
Each
$2,230.00
Plug
8"
Each
$3,000,00
Plug
12'
Each
$4,760.80
16'
Each
$5,000.00
Bond Amount (WASDj $
f 3 r 3 % k- , CD .. •
, . ,
, ,Tgal .project Cost $ $26,637.00yw
'Regional:- Server pump simian scamp stdTa1 asghborhoeds with o-lhersla3ons pompano to i1 &SUN mains bTreaimeni Plant
"LucaL• grrnt'ly systems. RI slalom & snail pump melons fn focal areas, force males carrying (taws from ISn to celeonal.
""•Eyolpmeni•• pump, mew/am/rte. piping, vein, eteclrital has, nacho. hoisted. Slrudure;• walls & s For egoipmani
The back of this document may be used In write In additional infor r .It eaded,
Certted by contractor. Signature:
3—
Type, size qua 'ty Inspected by: Signature:
Date; t: 1 Print: )c.
Da & Ived by iAtSinFt Signature:Ptin' ' `%Lp✓i [���
Company: 696 r >`i r i genera) cam" C•orP
Thu: \Pr
FINAL WAIVER AND RELEASE OF LIEN — DEVELOPER
Stale of Florida
County of Miami -Dade
, having been duly sworn, deposes and says as follows,. To wit
1, I, Arthur Noriega, as City Manager of CITY OF MIAMI, A MUNICIPAL CORPORATION (hereinafter called "the Devokper), with the right to execute this final
waiver and release of lien.
2 For the consideration of amount of len dollars ($ 10.00), the Developer hereby waives and releases all liens, tee rights, claims or demands of every kind whatsoever
which the Developer now has oe the construction of certain donated improvements, situated in Miami Dade County, Florida, described as:
All water & sewer facilities built constructed and installed to serve Grove Bay Parking Garage — PRASE 2, DW 2016-141& 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 as mom particularly described on Exhibit "B"
attached hereto and made a part hereof.
3. Developer understands that this is a weaver and release of lien which the Developer has against the facilities described herein. Developer acknowledge; that is
has been paid in full for all work related to the water & sewer facilities descnbed above.
4. Payments in full have heretofore been paid by the Developer to all persons, firms and eorporaUons supplying labor, materials, equipment and supplies, used
4irecty or indirectly by the Developer, or any subcontractor in the prosecution of the work provided on water & sewer facilities 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 that no assignment of liens or claims, 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 irrprovements described or listed herein, has been or will be made, and that no claims are outstanding by subcontractors andlor
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 any and all
liability, fosses or damages, inducing attorneys' Teas and costs of defense, which the Miami -Dade County or its officers, employees, agents or instrumentalities may
incur as a result of dams, demands, suits, causes of actions or pror eedngs of any kind or nature arising out of, relating to or resulting from the performance of work
by the Developer or its employees, agents, servants, partners, principals, contractors or subcontractors. Developer hereby agrees to pay all claims and losses in
connection therewith and shall 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 ail claims of any sorl as i1 may have against Miami -Dade County, al law or equity, arising out of the construction of the
above water & sewer Improvements_
WITNESSETH: CITY OF MIAMI, A MUNICIPAL CORPORATION
By:
Signature Signature
Todd B. Hannon, City Clerk Arthur Noriega, City Manager
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
The foregoing instrument was acknowledged before me this
day of
20 by ArthurNoriega as City Manager, and Todd B.Hamm
as City Clerk of CITY OF MIAMI, A MUNICIPAL CORPORATION. They are personally known to me or have produced
as identification and didldd not take an oath
NOTARY PUBLIC
Print name SERIAL NUMBER
TINAL WAIYSR AND RELEASE OF LIEN - CONTRACTOR
State of Florida
County of Miami -Dade
having been Buy swam, deposes and says as fdlcrws, To et
1. I am , President of GPE ENGINEERING 8 GENERAL CONTRACTOR CORP, A Florida Corporation
(hereinafter called 'the Contractor'], with the right to execute this final waiver and release of hen
2. For the consideration of amount of ten dollars ($10.43), the Contractor has agreed to hereby waive, release, and quit claim ail liens, lien rights, claims or demands
d every kind whatsoever which the Contractor now has or may hereinafter have against or as a result of tho construction of certain donalod irrTxovem nts, situated
in Miami Dade County, Florida, described as:
All water and sewer facilities bolt, conslni ted and installed to serve Grove I3ay Parking Garage -PHASE 2, DW 2016-144 & DS 2016-573, ID.229091ocated in
Section 22-54-41, Miami Dade County, Florida, as shown on Exhibit "A" attached hereto and made a part hered as more particularly described on Exhibit "B"
attached 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
acknowledges 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
drec1ty or indrecty by the Contractor, or any subcontractor In the prosecution of the work provided on water and sewer facilities described herein.
5. There are no claims, demands or liens of any 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 a the Members d the Board of County Commissioners.
5. The undersigned warrants that no assignment of liens or claims, nor the light to perfect a lien, such as the Notice to Omer provision under Section 713.06 (2)(a)
of the Florida Statutes, against improvements described or listed herein, has been or will be made, and that no claims are outstanding by subcontractors andlor
vendors to the Contractor.
7. The Contractor hereby agrees to irdermity and hold harmless Miarni-Dada Canty and its officers, employees, agents and instrumentalities from any and all
liability, losses or damages, in cluing attorneys' fees and costs d defense, which the Miami -Bade County or its officers, employees, agents or instnimer'talities may
incur as a result of claims, demands, suits, causes d actions or proceedings of any kind a 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 subcontractors. Contractor hereby agrees to pay ail clams and losses in
corxiection therewith and shall investigate and defend all claims, suits or actions dairy kinder nature in the name of Miami -Dade County, where applicable, inctudng
appellate proceedings, and shall pay all casts, judgments, and atlomey's fees which may issue thereon.
8. Contractor hereby waives and releases all claims of any sat as it may have against Miami -Dade Cony, at law or Nulty, arising out of the construction of the
above water and sewer improvements.
W1TNESSETH: GPI: EHGiPEERING & GENERAL CONTRACTOR CORP, A
Florida Corporation
Signature
By:
Print name Signature of President
5ignatae
Print none
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
The foregoing instrument was acknowledged before me this
day of
Print name
• 20 by - - as
President, of GPE ENGINEERING & GENERA. CONTRACTOR CORP, INC., A Florida Corporation. He/She is personally known to me or have produced
as identification and cidfdid not take an oath.
NOTARY PUBLIC
Print name SERIAL NUMBER
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, HIALEAH
GARDENS, FL 33018, who does hereby warrant to MIAMI-DADE 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 201E-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 "$" 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:
Signature
By:
GPE ENGINEERING & GENERAL
CONTRACTOR CORP, A FLORIDA
CORPORATION
Print name Signature of President
Signature
Print name
Print name
Tax Folio Number: 01-4122-002-00111
Agmt ID: 22909
- PHASE 2
GRANT OF EASEMENT
THIS INDENTURE, made this day of
20� between CITY OF MIAMI, A
MUNICIPAL CORPORATION, whose mailing address is: 444 SW 2nd
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: clo Mlaml-Dade Water and Sewer
Department, P.O. 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 hereof
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: CITY OF MIAMI, A MUNICIPAL CORPORATION OF THE
STATE OF FLORIDA
Signature
Todd B. Hannon, City Clerk
By:
Signature
Arthur Noriega, City Manager
STATE OF FLORIDA
COUNTY OF DADE
The foregoing instnament was acknowledged before me this day of
20_ by Arthur Noriega, as City Manager, and Todd B. Hannon, as City Clerk, of CITY OF MIAMI, A MUNICIPAL
CORPORATION OF THE STATE OF FLORIDA, an behalf of the corporation. I-le/She/They is/are personally known to me or
have/haven't has/hasn't produced as identification and did/did not take an oath.
NOTARY PUBLIC. SIGNATURE
PRINT NAME MY COMMISSION EXPIRES
This instrument prepared by
Utility Development Division
Miami -Dade Water and Sewer Department
3575 S. LeJeune Road
Miami, Florida 33146
"A" 1 of 1
EXHIBIT "A"
GROVE BAY PARKING GARAGE
LEGEND:
ENTER LINE
ILi =MONUMENT LINE
L4 =LEASE LINE
PM =RIGHT WAY
PB =PLAT BOOK
PG =PAGE
POC = POINT OF COMMENCE
POB _ POINT OF BEGINNING
POT = POINT OF TERMINATION
NOTES:
MIAMI-DADE WATER EASEMENT
FOLIO # 01-4122-002-0010
DW-2016-144
AGREEMENT ID# 22909
SECTION 22, TOWNSHIP 54 SOUTH, RANGE 41 EAST
MIAMI-DADE COUNTY, FLORIDA
LOCATION MAP
SCALE: 1" = 300'
I. ALL. DISTANCES AS SHOWN ARE BASED ON THE US SURVEY FOOT.
2. THE MINIMUM VERTICAL CLEARANCE OF THIS EASEMENT PS TWENTY FIVE (25)
FEET ABOVE GRADE
3. THESE EASEMENT STRIPS FROM A CLOSED GEOMETRIC FIGURE.
4. THIS SKETCH AND LEGAL DESCRIPTION IS NOT BOUNDARY SURVEY.
5, BEARINGS ARE BASED ON AN ASSUMED MERIDIAN, WHISRE THE CITY MONUMENT
LINES STARTING ON SW. 27TH AVENUE ALONG SOUTH BAY SHORE DRIVE OF
TRACT' A' OF DINNER KEY, ACCORDING TO THE PLAT THEREOF. AS RECORDED IN
PLAT BOOK 34. PAGE 2 Of PUBLIC RECORDS OF MIAMI-DADE COUNTY. FLORIDA.
BEARS NORTH 38'431' EAST.
5, NO TITLE SEARCH HAS BEEN COMGUCTED SY NOR WAS A TITLE REPORT
PROVIDED TO THE SURVEYOR,
7. THERE MAY BE EASEPIENTS, RIGHTS OF WAY AND/OR 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 CANSIDERED FULL, VALID AND
COMPLETE UNLESS ATTACHED TO THE OTHERS TOGETHER WITH THE SIGNATURE AND TFIE ORIGINAL
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 MITTEN CONSENT OF THE SIGNING PARTY OR PARTIES.
DAZE
WITHIN
2/,
WAS4 C.
3I,111320
NASD COZY.
2/24,2029
WASOCOWA.
COUNTY -WOE LA SURVEYORS, INC.
LINO SURVEYORS - PLANNERS
1535! S.W. 1401A. STREET
WAS, ft. S}lie
AFL•303.77107N
SURVEYOR'S CERTIFICATION:
SCALE: 1"= 300'
CERTIFIED TO MIAMI DADE COUNTY [WASEI
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 ACCOMPANY 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 STATUTES, AS
SET FORTH W CHAPTER S.F17, FLORIDA ADMINISTRATIVE CODE.
COUNTY -AIDE LAND SURVEYORS, INC. LB 4680
BATE OYaeRiB➢
GROVE BAY
PARKING GARAGE
3500 PANAMERICAN DRIVE
MIAMI, FL 33133
JCISEPFH L MARTIN PSFM4368
rHG#GNAL rJNEro6 + hempen
$/Alf Cr ULC A.
DATE: 02-14-2020
SCALE AS SHOWN
DW 2016-144
SHEET
1of3
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 632.12 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 77.62 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 15 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 57 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 THE
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 TOGETHER W1TH THE SIGNATURE AND THE ORIGBJAL
RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER ON PAGE 1 OF 3. ANY AGEmONS 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.
No. DATE t1E+IS 3N
y1yt68D
WASO COMM
3'111SR6
WASD CONY.
3' 4J 2D
W,ISO COAL.
COUNTY —VASE LARD SURVEYORS. INC.
LAND SURVEYORS — PLANNERS
t53S6 s.w. 1W1h SWEET
MIAMI. FL 33116
PM: SIM. 772.0766
GROVE BAY
PARKING GARAGE
3500 PANAMERICAN DRIVE
MIAMI, FL 33133
DATE: 02-14-2020 SHEET
SCALE AS SHOWN
DW 2016-144
2of3
GROVE BAY PARKING GARAGE
MIAMI-DADE WATER EASEMENT
FOLIO # 01-4122-002-0010
100 0 50 100 DW-2016-144
SECTION 22, TOWNSHIP 54 SOUTH, RANGE 41 EAST
GRAPHIC SCALE(IN FEET) MIAMI-DADE COUNTY, FLORIDA
SCALE: 1" = 100'
tl 3 l EXIST
Y I 't700DI:EASEMENT
•
i�f \ T2' WIS0
- EASEMENT
` lyy
l 1ccs
z.
q cc
h �
\ Lr}
I
•
3' 27
544"34'37"E
I 77.62'
t
pi l
�----__ JI -MAN
POC
fAl6 CITY OF MIAMI
MONUMENT T 4" BRASS
PIPE IN CONCRE SQUARE
TRACT 'A'
DINNER KEY
PE34,PG2
THE NORTHWESTERLY
EXTENSION OF THE HISTORIC
RIGHT-OF-WAY LINE AS
SHOWN ON THAT BOUNDARY
SURVEY 0!NNER KEY
CONVENTION cENTER'S
ADJACENT PARKING LOT`
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 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 N rI1ouT WRITTEN CONSENT OF THE SIGNING PARTY OR PARTIES
S44'34'37"E
394.43'
N74'51'03'W
9.00'
515'08'57"W
27.87'
DETAIL 'A' I 11;0.* `. por
Poe
N15'08'57"E
f'a+.ti.1
\
'\N\
N45'25'23'E
154.12'
4jJ1't:
PANAMEP/CAN Dr.
C.^•
\
\DCA,5\1\-\ c5 N15'08'57"E
1O, 27.87'
WATEASEMENT
S74'51'03"E
9.00'
POT
N15'08'57"E \
/r32.55'
DETAIL A A'
SCALD.1' - 20'
NP. DATE REVISION
2,113,32211
WASO COIN.
z
11112320
WAS000MIC
3E 232C
WASO COMM.
COUNTY -WIDE LAND SURVEYORS. INC.
LAND SURVEYORS - PLANNERS
ISSSO S.W. USN STQ#T
WALL FL 3.4196
PH: ]nl.27Zo]66
GROVE BAY
PARKING GARAGE
3500 PANAMERICAN DRIVE
MIAMI, FL 33133
DATE: 02-14-2020 SHEET
SCALE AS SHOWN
DW 2016-144
3 of 3
'NOTE: The Opinion must cover the time period to within 30 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 TFIROUGH THE DATE OF EXECUTION OF THE DEED, EASEMENT, COVENANT OR 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 on 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
1_ 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 materialmen's liens.
5. Zoning and other restrictions imposed by governmental authority
SPECIAL EXCEPTIONS No LJ Yes (please disclose)
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.
I, the undersigned, further certify that I am an attorney -at -law duly admitted to practice law in the State of Florida and am a member in
good standing of the Florida Bar.
Respectfully submitted this
SIGNATURE
day of _ 24
PRINTED NAME FLORIDA BAR NUMBER
ADDRESS 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
PRINCIPAL
(Corporate Name)
ATTEST:
By: By:
Secretary President
SURETY
(Corporate Name)
By: By:
(Signature of Resident Florida Agent)
Title:
POWER OF ATTORNEY FOR RESIDENT FLORIDA AGENT MUST BE ATTACHED.
Form W-9
(Rev, October 2018)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
identification Number and Certification
■ Go to www.frs.gov/FormWN9 for Instructions and the latest Information.
Give Form to the
requester. Do not
send to the IRS.
iz
0
1 Name (as shown on your income fax return). Name is required on this tine; do net leave this line blank.
2 Business name/disregarded entity name, If different from above
3 Check appropriate box for federal tax classification of the person whose name is enleied on Ilne 1, Check only oni of the
following seven boxes.
IndividuaVsole proprietor C Corporation ❑ 5 Corporation ❑ partnership ❑ Trust/estate
single -member Ll_G
❑ 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. Do not check
LLG if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is
another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
• Other (see instructions)*
5 Address (number, street, and apt or suite no.) See instructions.
Taxpayer Identification Number (TIN)
4 Exemptions (codes apply only to
certain entities, not individuals; see
Instructions on page 3):
Exempt payee code (if any)
Facemplion from FATCA reporting
code (if any)
ittriba baccount' married wakfe Sid U.S)
Requester's name and address (optional)
Enter your T1N in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
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
77N, later,
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and
Number To Give the Requester for guidelines an whose number to enter.
social security number
or
r
Employer identification number
Part II
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my con-ect taxpayer identification number (or l am waiting fora number to be issued to me); and
2. l am not subject to backup withholding because: (a) 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. I am a U,S. citizen or ether U.S. person (defined below); and
4. The FATCA codes) entered on this form (deny) indicating that I am exempt from FATCA reporting is correct.
Certification 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 return. 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 the instructions for Part tl, later.
Sign
Here
Signature of
U.S. person ■
Date ■
General instructions
Section references are to the Internal 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 www.irs.gov!FoimW9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(SSN), individual taxpayer identification number (ITIN), 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 information
returns include, but are not limited to, the following,
• Form 1099-tNT (interest earned or paid)
• Form 1099-DIV (dividends, including those from stocks or mutual
funds)
▪ Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-I3 (stock or mutual fund sales arid certain other
transactions by brokers)
• Form 1099-S (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),
1098-T (tuition)
• Form 1099--C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct 11N.
ff you do not retum Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat. Na. 10231 x
Form Bill-9 (Rev. 10-20181
MIAMI•QAL7
COUNT(
mlamidadr„gov
NEW ACCOUNT WORK FORM
Please complete highlighted areas only
SP CREATE DATE:
Water and Sewer
PO Box 33016
Miami, EL 33233-0316
T 786-268-5360
Customer None:
55 # or Federal Tax ID#;
E-Mail Address:
Daytime phone number(s):
C(1) 0 2.
Mailing Address:
City: State: Zip:
PLEASE NOTE: Customers) requesting meters will be responsible for all bills until a Disconnect or Transfer of Service(s) 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 andf 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.mlamldade.gov/water/desigr-construction-standards.aspitpart4
Name and Title of Person Authorizing Application:
SIGNATURE:
DATE:
#of Units/
SO FT:
Premise Address:
Folio #:
MTR Location:
GPD:
SP Size:
Mtr Size:
LOT:
BLX:
Customer ID/Invoice No.
OP Area:
Munldpallty:
Premise Type:
subdivision;
lip Cade;
Quarterly ❑
Monthly Q
W&5 [] water Meter lnstaifation Fees:
wooly ❑ EJ Yes ❑ No
Premise Case (Notes) (s): Premise Case ID:
LI NEEDS FOLIO'S ❑NEEDS MTR LOCAT MTR SET REQ:NEEDS SS# or FEDERAL TAX ID
Agreement#
Conveyance Required;
❑Yes ❑ No
"G' Restriction
Yes ®No
`1
®yes ❑ Na
VF Number
ER water:
NBR NAME:
Processed Date:
NBR5ignature:
Must provide WASD at least two schedule dates not sooner than 5 days
ER Sewer;
Supervisor Name:
Approved Date:
Supervisor Signature:
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