2317 Seminole Rd ROW23-0030 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
MEISER CARROLL K 2317 SEMINOLE RD ATLANTIC BEACH FL 32233-5925
COMPANY:ADDRESS:CITY:STATE:ZIP:
ALL PRO ASPHALT 1901 HILL ST JACKSONVILLE FL 32202
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
168908 1216 BLUFFS
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
2317 SEMINOLE RD RIGHT OF WAY SINGLE OR TWO
FAMILY RIGHT OF WAY ROW FOR PAVING $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 UTILITIES UNDERGROUND WATER SEWER UTILITIES INFORMATIONAL
Notes:
Avoid damage to underground water and sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is
needed, call 247-5878. State Law requires calling Sunshine 811 to have ALL public utilities located BEFORE beginning the work.
2 PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL
Notes:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line (904-247-
5814) to request an Erosion and Sediment Control Inspection prior to start of construction.
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: 8/31/2023
PERMIT NUMBER
ROW23-0030
ISSUED: 8/31/2023
EXPIRES: 11/29/2023
RIGHT OF WAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PU REVIEW BUILDING MOD OR ROW 001-0000-329-1007 0 $25.00
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
TOTAL: $50.00
3 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.
4 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
5 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.
6 PUBLIC WORKS GRASS INFORMATIONAL
Notes:
Full site to be grassed.
7 PUBLIC WORKS REVISION INFORMATIONAL
Notes:
Any plan change must be submitted as a Revision to the Building Department.
8 PUBLIC WORKS DEBRIS REMOVED INFORMATIONAL
Notes:
All construction debris must be removed from job site by Contractor.
9 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
2 of 2Issued Date: 8/31/2023
PERMIT NUMBER
ROW23-0030
ISSUED: 8/31/2023
EXPIRES: 11/29/2023
RIGHT OF WAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION ALL INFORMATION
City of Atlantic Beach HIGHLIGHTED IN GRAY IS
800 Seminole Road,Atlantic Beach, FL 32233 REQUIRED.
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address Z 3 17 Sthq n0lG coin WI" c r-L Permit Number INo.1)Z J- UDsO
Contractor Information (
I
Company NSI Pro Qualifying Agent J3rc mac. Purc,Zlk
Address (gc)I Fri City State FL Zip 3ZZ oZ
Phone (-1oy - 3;5 - )-7-7 G Email R'pLdrit 'i Ail ?ro AS wI+",11Z',-
State Certification/Registration# / 0 Cq .V4
Architect N/A Phone N`6 - Email Ivff{
Engineer Ek Phone v l/` Email N/Pc
Workers Compensation Insurer TAP ,?ef1( /-i OR Exempt f Expiration Date J j /3 2?,
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 performed under the
supervision of fS r 'c. -F..-c4' Project Superintendent)
with (Company Name) Phone "1"/ - -/7 to - /$G'
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 the
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 30 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 attempted 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 ye/ 5
Permittee(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this
i
Ig day of A 9 vs 20 23 ,
by rC,e— P(/rW I
I`
who personally appeared before me and
printed name of Permittee)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
KIM SELLERS
MY COMMISSION#HH 358266
4.4":;‘,. • EXPIRES:February 5,2027
VPersonally Known
Signature of Notary Public,State of Florida j Produced Identification(Type)
H:\Applications&Forms\Word Documents\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18
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