M
iami
S
hores
V
illage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
SURVEY AFFIDAVIT
STATE OF (FLORIDA)
COUNTY OF (DADE)
The undersigned Affiant, __________________________, does hereby attest that
(Property owner)
The attached survey, performed by ___________________________________________
(Name of surveyor’s company)
For address: ______________________________________________________________,
Performed on ______________ (date of survey) is an accurate representation of the existing conditions and
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property
without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to
remove or obtain permits for any structures which now may exist on the property which are not permitted or which
may violate zoning or building code regulations. The Affiant further understands that the existence of any such
structures may affect final inspections as applicable to this or other permits.
Further, Affiant say eth naught.
__________________________ _____________________________
Property Owner Signature Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this __________day of _______________.
Affiant is ______personally known to me, _______produced ______________________as identification.
____________________________
Notary
Revised on 5/22/2009/ Revised on 6/12/09
