2009 Selva Marina Dr ROW23-0024 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
CHAMBERS RONALD W 2009 SELVA MARINA DR ATLANTIC BEACH FL 32233-4553
COMPANY:ADDRESS:CITY:STATE:ZIP:
Jacksonville Electric
Authority 225 N Pearl St Jackonville FL 32207
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169506 1012 SELVA NORTE UNIT 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
2009 SELVA MARINA DR RIGHT OF WAY SINGLE OR TWO
FAMILY RIGHT OF WAY Directional bore $0.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 PUBLIC WORKS DUMPSTERS/ROLL-OFF CONTAINERS INFORMATIONAL
Notes:
Dumpsters and roll-off containers must be used in compliance with Section 16-8 and must comply with all standards, per City code.
2 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies, or federal agencies.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 2Issued Date: 7/25/2023
PERMIT NUMBER
ROW23-0024
ISSUED: 7/25/2023
EXPIRES: 10/23/2023
RIGHT OF WAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
TOTAL:
3 PUBLIC WORKS UTILITY ROAD CUT INFORMATIONAL
Notes:
Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid 10 feet in each direction from the center of the cut.
Repair must be shown on the plans.\r\r\r\r\r\r\r
4 PUBLIC WORKS CONSTRUCTION SITE MANAGEMENT INFORMATIONAL
Notes:
Provide construction site management plan, including location of silt fence, dumpster, portable toilet. Right-of-Way Permit is required if using right-of-
way for construction parking.
5 PUBLIC WORKS GRASS INFORMATIONAL
Notes:
Full site to be grassed.
6 PUBLIC WORKS REVISION INFORMATIONAL
Notes:
Any plan change must be submitted as a Revision to the Building Department.
7 PUBLIC WORKS DEBRIS REMOVED INFORMATIONAL
Notes:
All construction debris must be removed from job site by Contractor.
8 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
2 of 2Issued Date: 7/25/2023
PERMIT NUMBER
ROW23-0024
ISSUED: 7/25/2023
EXPIRES: 10/23/2023
RIGHT OF WAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
H:\Applications & Forms\Word Documents\201801001 Right-of-Way Easement Permit Application.docx Revision Date: 10/1/18
**ALL INFORMATION
HIGHLIGHTED IN GRAY IS
REQUIRED.
RIGHT-OF-WAY / EASEMENT PERMIT APPLICATION
City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address_________________________________________________ Permit Number________________________
Contractor Information
Company______________________________________________ Qualifying Agent_____________________________
Address______________________________________ City________________________ State______ Zip___________
Phone________________________________________ Email_______________________________________________
State Certification/Registration #_______________________________________________________________________
Architect_____________________________________ Phone____________________ Email______________________
Engineer_____________________________________ Phone____________________ Email_______________________
Workers Compensation Insurer ____________________________________ OR Exempt □ Expiration Date __________
Permittee declares that prior to filing this application they have ascertained the location of all existing utilities, both aerial
and underground and the accurate locations are shown on the sketches.
Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation, alteration or
relocation of all, or any portion of said street or easement as determined by the Public Works Director, any or all said poles,
wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from said
street or easement or reset or relocated hereon as required by the Public Works Director and at the expense of the
Permittee unless reimbursement is authorized.
All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be per formed under the
supervision of ____________________________________________________________________ (Project Superintendent)
with (Company Name) ________________________________________________Phone_____________________________
All materials and equipment shall be subject to inspection by the Public Works Director.
All city property shall be restored to its original condition as far as practical, in keeping with City specifications and th e
manner satisfactory to the City.
A sketch of plans covering details of this installation, as well as a copy of a recent survey shall be made a part of this permit.
Calculations showing any increase in impervious area on owner’s lot or in the City right -of-way are to be included with
this application.
The permittee shall commence actual construction in good faith within _______ days. If the beginning date is more than 60
days from date of permit approval then permittee must review the permit with the Public Works Director to make sure no
changes have occurred in the area that would affect the permitted construction.
It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City’s right,
title and interest in the land to be entered upon and used by the holder, and the holder will, at all times, assume all risk of
and indemnify, defend and save harmless the City of Atlantic Beach from and against any and all loss, damage and cost of
expenses arising in any manner of the exercise or attempte d exercises by the holder of the aforesaid rights and privileges.
The Public Works Director shall be notified 24 hours prior to starting work and again immediately upon completion.
_______________________________________________________________________________ Date________________________
Permittee (signed in presence of Notary Public)
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this ___________ day of ________________________________________, 20 _________,
by _______________________________________________________________________, who personally appeared before me and
(printed name of Permittee)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
__________________________________________________________ [ ] Personally Known
Signature of Notary Public, State of Florida [ ] Produced Identification (Type) _______________________
MIN 42"****************************
* DRAWING NOT TO SCALE *
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requirements prescribed in Section 471 Florida Statutes.
of the UAO and are exempt from the signing and sealing
The plans were prepared by a regular full-time employee
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PHONE NO:
ENGINEER:
DISTRIBUTION ENGINEERING
SCHEMATIC
PERMIT
JASON CONNER 665-8682
8 DEG
ANGLE-
EXIT
8 DEG
ANGLE-
ENTRY
STA.1
ENTRY PIT
STA.2
EXIT PIT
BORE
PROFILE OF DIRECTIONAL
MAX 16" REAMER
4-6" HDPE
DIRECTIONAL BORE