Reso 2013-2154 - Laserfiche WebLink

Home Browse Search

M1��• Class I Permit Application Application must be filled out in its entirety. Please indicate N/A for non - applicable fields. 1. Applicant Information: 2. Applicant's Authorized Permit Agent: Name: City of Sunny Isles Beach Agent is allowed to process the application, furnish supplemental information relating to the application and bind the applicant to all requirements of the application Address: 18070 Collins Avenue Name: s• Q..440 ��cAA -- Sunny Isles Beach, Florida Zip Code: 33160 Address: t�0 % O EJ ;A.% 1� Phone #: Fax #: &w1l4 Zip Code: -T 3 1 ie O Email: Phone #: A O 1 Fax #:.?qg 793L-1654 , This should be the applicant's information for contact purposes. Email: `_ mun, a5,60_ ne± 3. Location where proposed activity exists or will occur (latitude and longitude are only necessary for properties without address or folio #): Folio #: 31 -2211- 004 -0211, 31- 2211- 070 -0001, and 31 -2211- 066 -0045 Latitude: Longitude: Street Address: North Bay Road between 17211 Street and 1741h Street Section: II Township: 52 Range:42 In City or Town: Sunny Isles Beach Near City or Town: Name of waterway at location of the activity: Town Center Park Canal 4. Describe the proposed activity (check all that apply): 6. If the proposed work relates to the mooring of vessels provide the following information ❑ Seawall ❑ Dock(s) ❑ Boatlift ❑ Dredging ❑ Mangrove Trimming ❑ New/Replacement Seawall ❑ Pier(s) ❑ Mooring Piles ❑ Maintenance ❑ Mangrove Removal ❑ Seawall Cap ❑ Viewing Platform ❑ Fender Piles ❑ New ❑ Batter Piles ❑ Davits ❑ Filling ❑ King Piles ❑ Utility Total Number of Slips: Not Applicable ❑ Footer /Toe Wall Issuing Agency Type of Approval Identification Number Application Date Approval Date ❑ Riprap ]d Other: New Fixed Bridge Estimated project cost = $ 3,5000,0000.00 Are you seeking an after - the -fact approval (ATF)? ❑Yes IR No If "Yes", describe the ATF work: 5. Proposed Use (check all that apply): 6. If the proposed work relates to the mooring of vessels provide the following information (please also indicate if the applicant does not have a vessel): ❑ Single Family ❑ Multi- Family Proposed Vessel Type (s): Not Applicable ❑ Private I9 Public Vessel Make /Model (If known): Not Applicable ❑ Commercial Draft ( s)(range in inches.): Not Applicable Length (s)(range in feet.): Not Applicable ❑ Industrial ❑ Utility Total Number of Slips: Not Applicable 7. List all permits or certifications that have been applied for or obtained for the above referenced work: Issuing Agency Type of Approval Identification Number Application Date Approval Date