1991 Mipaula Ct RFNC23-0090 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
DAY JAMES A 1991 MIPAULA CT ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
TOP FENCE LLC 4507-2 SUNBEAM RD JACKSONVILLE FL 32257
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169506 1032 SELVA NORTE UNIT 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1991 MIPAULA CT RESIDENTIAL FENCE ONE
STREET FRONTAGE
Installing 226' of 5'
aluminum 3 rail fence with 3
-5' gates
$8700.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ZONING FENCE PLAN REVIEW FEE 001-0000-329-1003 0 $35.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 BUILDING NOTICE OF COMMENCEMENT INFORMATIONAL
Notes:
No inspections may be scheduled until a copy a recorded Notice of Commencement has been submitted to the Building Department
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: 9/25/2023
PERMIT NUMBER
RFNC23-0090
ISSUED: 9/25/2023
EXPIRES: 3/23/2024
RESIDENTIAL FENCE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
TOTAL: $35.00
2 of 2Issued Date: 9/25/2023
PERMIT NUMBER
RFNC23-0090
ISSUED: 9/25/2023
EXPIRES: 3/23/2024
RESIDENTIAL FENCE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Building Permit Application Updated 10/9/18
1. City of Atlantic Beach Building Department ALL INFORMATION
1800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email:
IS RE(
QUIREI
inCD./
Job Address: 1991 Mipaula Ct Atlantic Beach FL 32233 Permit Number: --FNC.: v I t/
Legal Description Installing Fence For backyard RE# 169606-1032
Valuation of Work(Replacement Cost)$ $8,700 Heated/Cooled SF Non-Heated/Cooled
Class of Work: New *ddition "Alteration Repair Move Demo Pool "'Window/Door
Use of existing/proposed structure(s): "'Commercial It Residential
If an existing structure,is a fire sprinkler system installed?: Yes )(No
Will tree(s)be removed in association with proposed proiect? "Nes(must submit separate Tree Removal Permit) gNo
Describe in detail the type of work to be performed: installing 226' of 5' black aluminum 3 rail fence with 3-5'
gates to enclose backyard
Florida Product Approval# for multiple products use product approval form
Property Owner Information
J.
Name ,S tr ,d DANE -:,:i.1 tif ti, 1 Address 1491 fi pqula CH-
CityCity Atlon-ic ())e041State FL Zip 32.2-33 Phone $,59-8A,-O01b
E-Mail SaS•IL_day 0]tr#agd.wa
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company -top if/1GG LLC- Qualifying Agent lase pk 11.4'.1y
Address }15Q7 Sunbeam Rd ladesd u:lle ,f2- 32257 City Yc u:Ilt State FL- Zip 322,5'7
Office Phone Job Site Contact Number 10L1 iq4-9-7n4
State Certification/Registration# E-Mail -r..54k. '4-fence,to& ,i.tdnh
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt,i$' Expiration Date CI I ac 2_/
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. 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.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING Y)QUR NpTICE OF,COMMENCEMENT.
Signature of Owner or Agent) i Signature of Contractor)
Th
Signed and sworn to(or affirmed)before me this2O day of Signed and sworn to(or affirmed)before me this a) day of
w ftn.btr, 2.0- .by S ,,, 5,;601.X.,Y3 , by -ScSeph K`''V
A
L$
na ure oPNotary BRa' 9 ..o ary
LUKE GILLIAM MARISSALORDAMYCOMMISSION#HH 352746 i ;, MY COMMISSION#HH 228158 '
c EXPIRESJanuar 23,2027 ersonall Known ORt " ,7"7 , EXPIRES:June 12,2026
Personally Known OR t Y oai.,,('
Produced Identification V Produced Identification w
Type of Identification:)Id'•d-+ 1D -va- L• wsr./ Type of Identification: I'(-1.1,CYS 11((rSSe-
DocuSign Envelope ID:67373AF4-128F-4DCC-9E75-D5E940B6DF7E
e.,,._ ,,Fence Addendum Updated 1/14/2021
City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233 PERMIT # ' -C2''-0viO
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
1991 Mipaula Ct Atlantic Beach FL 32233 09/19/23
Property Type: Lot Type/ Features:
Residential f One Street frontage (interior lot)
Commercial More than one street frontage (corner lot, through lot,
etc.)
Swimming Pool
Fence Material: Fence Height (select all that apply):
Wood Four Foot(4ft)
Chain Link Six Foot(6ft)
Vinyl kl Other 5 -c-k-
Block/Stone (Plan details required for footings and/or
retaining walls)
IX.Other Altaninto
Fence Location:
Please submit an accurate and current boundary survey showing all existing improvements (including building footprint,
driveway, swimming pool, etc.) and location of fence/wall and any gates. Plan details required for block wall footings and/or
retaining walls and any portion or fencing above 6ft in height.
Will the fence be built in an easement?
Cl Yes (must submit separate Revocable Encroachment Agreement)
No
Will tree(s) be removed in association with proposed project?
Yes (must submit separate Tree Removal Permit)
No
Conditions of Approval:
II •
Roll off container company must be on City approved list. Roll off container cannot be placed on City right-of-way.
All old fencing and debris must be removed from job site by contractor or homeowner.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
I
MAP SHOWING SURVEY OF1LOT16, SELVA NORTE, UNIT ONE, ACCORDING TO
THE PLAT THEREOF AS RECORDED IN PLAT BOOK
y I 39, PAGES 94, 94A AND 948 OF THE CURRENT I ;:'PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
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DocuSign Envelope ID:67373AF4-128F-4DCC-9E75-D5E940B6DF7E
OP
FENCE
l.l.c
P:(904)999-9779 Email:TopFenceLLC@gmail.com
Name of Homeowner:
James Day Purchase Agreement Date
09-18-23
1991 Mipaula Ct
Vin l IAluminumAddress: Fence Style: Woody
Email: Sasaki_day@hotmail.com Height of Fence:4'0 4.5'Igt 5' 6' 8'
Cell Phone/Home: 859-806-0096 Estimated installation time frame: 2-3 weeks
After permit recieved
Neighborhood/HOA Atlantic Beach
Description of Work Performed: Price Cash Option
FENCE ERECTION AND INSTALLATION Total Cost Installed: $ 8,700 Down Payment:
Payment Type:
Credit Card Information 4,350
peg'
CpIsc APP Card Type: MasterCard VISA Final Payment
DISCOVE AMEX
ApeEPAY
WK.
f Other: 4,350
CASH/CHECK
Card Holder Name.
CREDIT CARD
Bank Transfer .\
Card Number:
Expiration te: VV:
Card Hol er Zip Code:
BALANCE DUE AND PAYABLE NO LATER THAN 48 HOURS AFTER DATE OF FINAL INSTALLATION.Homeowner shall remit full and complete payment
on the day of final installation and/or no later than 48 hours from the date of final installation. If final payment is not remitted in full 48 hours of the final installation date,
then Top Fence has the option,in its own discretion,to terminate this Agreement,place the appropriate lien(construction lien,among others)on the subject property,and the
property owner will forfeit any and all claims to his or her down payment and/or initial deposit. If the Homeowner is not satisfied with the final installation,the Homeowner
does NOT have the right to withhold payment;instead,Homeowner may seek a cure pursuant to the terms and conditions of this Agreement. Accordingly,final payments
MUST be remitted despite changes and/or requested modifications.
SECURITY/CONSTRUCTION LIEN.Top Fence may place a lien on your home through a fixture filing(UCC-1)and/or construction lien,as a result of this Agreement.
TOP FENCE RESERVES THE RIGHT: To substitute make&model of fencing materials as long as it is substantially similar to the materials agreed-to by the
homeowner(s).
LIMITATION OF LIABILITY.To the extent permitted by law,in no event shall the Top Fence's aggregate liability,if any,in damages or otherwise,arising out of or
related to any products,installation of any product,service or repair work,and or any other action,and whether any claim relating thereto is based in contract,tort,or
otherwise,shall in any circumstance exceed the purchase price actually paid by Homeowner(s) for such product. Top Fence shall not be liable for any incidental,
consequential or special damages or for economic loss or expense or for loss or profits of Homeowner(s).
ENTIRE AGREEMENT/MERGER/INTEGRATION/MODIFICATION.This Agreement and all attachments hereto constitute the entire agreement between the
Parties&may only be modified in writing. All prior&contemporaneous agreements,representation statements,negotiations,understandings&undertakings are
superseded by this Agreement and the only inducement to enter into this agreement.
DocuSign Envelope ID:67373AF4-128F-4DCC-9E75-D5E940B6DF7E
TERMS&CONDITIONS.Uwe agree to&accept the General Terms,Conditions,and Disclosures of this Agreement&further acknowledge receipt of a completed copy
of the attached general terms and conditions,notice of cancellation forms attached.Florida residents receive a required notice form attached.
REFUND/CANCELLATION POLICY After 72 hours of deposit collected on a project,deposits are non-refundable.Top Fence has the right to keep full deposit after 72
hours since materials are purchased right away with no refund,zero exceptions.Top fence has the right,at their own discretion,to agree to partial returns that can be used for
future projects which will be used as a credit for future projects.However,Top Fence has the right to decline the partial return,and retain full deposit
PROPERTY SURVEY. It is the homeowner(s)'responsibility to have the property surveyed so that Top Fence may determine the appropriate property lines. Top Fence
will assume no responsibilities for any damaged underground cables,sprinklers,unmarked buried lines,and/or utilities.
RIGHT OF ACCESS. The homeowner(s)will grant Top Fence the right of access and removal in the event that the Homeowner(s)'defaults in this Agreement. In such
case,Top Fence will be allowed and permitted to remove any and all materials installed in the subject property.
FINAL WALKTHROUGH. Homeowner will conduct a final walkthrough on his or her own to confirm or dispel his or her own approval of the work conducted. Should
there be any dissatisfaction with said work,Homeowner shall notify Top Fence,so that Top Fence may elect,in its own discretion,to modify or fix said dissatisfaction. In
case of dissatisfaction after final installation,the Homeowner shall notify Top Fence within 48 hours of final installation date. If Homeowner does not notify Top Fence of
any dissatisfaction within 48 hours from final installation date,said work will be deemed accepted and final.
FENCING FIXTURE WILL BE INSTALLED AS REFERENCED IN THE ATTACHED DRAWING
DocuSigned by:
9/19/2023
jAsJames Day
BUYER SIGNATURE:,
B26 DBA1A3c2_
PRINT NAME: DATE:
CO BUYER'S SIGNATURE: PRINT NAME: DATE:
GENERAL TERMS,CONDITIONS AND DISCLOSURES
1.Demand,Acceleration&Collection.If the Homeowner(s)refuses to complete the installation as agreed or defaults under any terms of the Agreement,the entire
balance of this Agreement shall accelerate and become due and payable immediately. Homeowner(s) shall be liable for all collection costs. In any suit or
proceeding arising out of or in connection with the Agreement,the prevailing g party shall be entitled to recover reasonable expenses,including,but not limited to,
attorney's fees,costs and expenses and 1%interest on unpaid balance.Top Fence also may have the option of removing all or part of the material from the
Homeowner(s)'premises in addition to receiving payment of the balance.
2 Waiver(s).Unless otherwise provided by statute or applicable law,Homeowner(s)acknowledges that once work has commenced,Homeowner(s)has waived
his/her right to cancel.Once installation or repair work of any product or service is substantially completed,pursuant to your request for repair,maintenance or
installation;then such work,services or products installed cannot be returned or un performed in a way as to return the purchased items or services in a condition
prior to installation.
3. Manufacturers and Product to Warranty:Top Fence agrees to pass any and all existing product and manufacturer's warranties,if any,to the Homeowner(s).
4. Limitations/Exclusions on Warranties.Top Fence does not make any representations or warranties except for this set out in this Agreement and/or those
warranties which cannot be excluded from this Agreement.Top Fence shall provide limited warranties in compliance with the minimum standards of applicable
state and local rules and regulations in which it operates.All warranty coverage to equipment and workmanship installed by Top Fence are passed through and
provided by the manufacturer which shall be void if any alterations or repairs are performed by any person or persons not expressly authorized,in writing by Top
Fence.The warranty does not cover:weather,vandalism or damage caused by external forces such as an act of God;normal wear and tear or aging of material;
any implied warranties;additional electric bills,water damage or any other consequential damages to the property;damage to the system or its efficiency due to
adjustment, moving or tampering with components by individuals other than those specified by Top Fence . TO THE EXTENT PERMITTED UNDER
APPLICABLE LAW,THE LIMITED WARRANTY SET FORTH HEREIN IS EXPRESSLY IN LIEU OF THE WARRANTIES OF MERCHANTABILITY,
AND OF FITNESS FOR A PARTICULAR PURPOSE,USE,OR APPLICATION,AND ALL OTHER OBLIGATIONS OR LIABILITIES ON THE PART OF
TOP FENCE,UNLESS SUCH OTHER WARRANTIES,OBLIGATIONS OR LIABILITIES ARE EXPRESSLY AGREED TO IN WRITING AND SIGNED
AND APPROVED BY TOP FENCE OR REQUIRED UNDER APPLICABLE LAW.TOP FENCE SHALL HAVE NO RESPONSIBILITY OR LIABILITY
WHATSOEVER FOR DAMAGE OR INJURY TO PERSONS OR PROPERTY OR FOR OTHER LOSS OR INJURY RESULTING FROM ANY CAUSE
WHATSOEVER, WHETHER ARISING OUT OF OR RELATED TO THE PRODUCTS, INCLUDING WITHOUT LIMITATION, ANY DEFECTS IN
PRODUCTS, OR FROM USE OR INSTALLATION. UNDER NO CIRCUMSTANCES SHALL THE TOP FENCE BE LIABLE FOR INCIDENTAL,
CONSEQUENTIAL OR SPECIAL DAMAGES OF ANY TYPE, INCLUDING WITHOUT LIMITATION RELATING TO LOSS OF USE, LOSS OF
PROFITS,LOSS OF PRODUCTION OR LOSS OF REVENUE.
5.Transfer.If Homeowner(s)lists or sells the Property after acceptance and prior to payment in full for the Products,then Homeowner(s)agrees that,in addition
to Homeowner(s)remaining as an obligor and guarantor on the debt,the outstanding money shall be secured by the Property by a lien senior to any subsequent
lienholders.
6.Indemnity.Homeowner(s)shall indemnify and not hold Top Fence,its affiliates,agents,officers,representatives and employees liable for any damage or injury
to Homeowner(s),or any other person,or to any property,occurring on the premises,or in common areas,unless such damage is the legal result of negligence or
willful misconduct by Top Fence,his or her agents or employees.
7. Severability.If any provision or any part of a provision of this Agreement shall be held invalid or unenforceable,then the remaining portions of that provision
and the remainder of the Agreement shall be construed as if not containing the particular invalid or unenforced able provision or portion thereof,and the rights
and obligations of each Party shall be construed and enforced accordingly.
8.Time to Cure. In the case of any deficiencies,human error,and/or delay,the Homeowner(s)shall not initiate any legal proceeding/arbitration against Top
Fence. Instead Homeowner(s)shall notify Top Fence of the discrepancy and permit Top Fence 30 days to cure said discrepancy.
9. Mediation and Arbitration. In the event of any controversy or claim arising out of or relating to this Agreement,or a breach thereof,the Parties hereto shall
first attempt to settle the dispute by mediation,administered by the American Arbitration Association. If settlement is not reached within sixty days after service
of a written demand for mediation,any unresolved controversy or claim shall be settled by arbitration administered by the American Arbitration Association
under its Commercial Arbitration Rules. The number of arbitrators shall be one(1). The place of arbitration shall be in Florida.
r—DocuSig nide/
1dAby.
y.
HOMEOWNER(S)SIGNATURE:
awtt,S James Day
I PRINT NAME: DATE:
9/19/2023
e2bFUCA IHS1341.2
2
DocuSign Envelope ID:67373AF4-128F-4DCC-9E75-D5E940B6DF7E
CO-HOMEOWNER(S)SIGNATURE: PRINT NAME: DATE:
TOP FENCES SIGNATUR yE:PRINT NAME: I`^Jr DATE: 09-13-23
NOTICE OF CANCELLATION
DATE OF TRANSACTION:
YOU MAY CANCEL THIS TRANSACTION,WITHOUT ANY PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE.
IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY NEGOTIABLE
INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN 10 BUSINESS DAYS FOLLOWING RECEIPT BY THE MERCHANT OF YOUR
CANCELLATION NOTICE,AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED.
IF YOU CANCEL,YOU MUST MAKE AVAILABLE TO THE MERCHANT AT YOUR RESIDENCE,IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN
RECEIVED,ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR YOU MAY IF YOU WISH, COMPLY WITH THE
INSTRUCTIONS OF THE MERCHANT REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE MERCHANT'S EXPENSE AND RISK.
I HEREBY CANCEL THIS TRANSACTION.Date(buyer's
Signature)
3
iil Revision Request/Correction to Comments ALL INFORMATION
HIGHLIGHTED IN1"
jCity of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: FNL2-, _0 V
Revision to Issued Permit OR Corrections to Comments Date: 9/2Z/20 zj
99I /2pCl t l, C 1f/ f'C 8t fi32233ProjectAddress: SRA c
Contractor/Contact Name:Jq17 e -14-TA A i
f
Contact Phone: (1 5 l (o / ? < f(r/6 Email: 14if 6,j I.C/47y 6247414 i / . C o 4-7
Description of Proposed Revision/Corrections:
54/Ij/ h;49 r•C' VO Cot CA l2 C /`U4t c Lt //, c.! f'Gi /'QP,,IC-1
74-
I
Jj
6 4l _f6 J A K 1 affirm the revision/correction to comments is inclusive of the proposed changes.
printed name)
Wi proposed revision/corrections add additional square footage to original submittal?
No Yes (additional s.f.to be added:
II proposed revision/corrections add additional increase in building value to original submittal?
No *Yes (additional increase in building value: $ Contractor must sign if increase in valuation)
Signature of Contractor/Agent:
Office Use Only)
Approved Denied Not Applicable to Department Permit Fee Due$
Revision/Plan Review Comments
Department Review Required:
Building
Planning&Zoning Reviewed By
Tree Administrator
Public Works
Public Utilities
Public Safety Date
Fire Services Updated 10/17/18
REVOCABLE ENCROACHMENT AGREEMENT
City of Atlantic Beach
ALL INFORMATION
HIGHLIGHTED IN GRAY
800 Seminole Road,Atlantic Beach, FL 32233
IS REQUIRED.
REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida,a municipal corporation organized and
existing unicler the laws the State of Florida, hereinafter referred to as"CITY" and
6'Q cj A ki of Atlantic Beach, Florida, hereinafter
referred to as"USER".
WITNESSETH:
That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the
property for the purpose as described in the City of Atlantic Beach.
This work is generally described as Qn,C L
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to
relocation or removal on thirty(30)days'notice by CITY to USER,said no ice to USER shall be give by certified mail,return
receipt requested,to the following address / 9/ m / Cr v
notice
6— /i-74'4ti, /L,
L gQ
In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter
upon the above described easement or property of the CITY, the USER shall replace at the USER's sole expense,
any and all material necessarily displaced during the action of maintaining,repairing,operating,replacing or adding
to of the utilities and facilities of the CITY or franchise utility provider.
The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land
Development Code and all other land use and code requirements of the CITY, including City Code Section 19-7(h)
which states "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but must
be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks."
The USER, prior to making any changes from the approved plans and/or method, must obtain written approval
from the City of Atlantic Beach Public Works Department, for said change within 30 days after the day of
completion.
This permit shall inure to the benefit of,and be binding upon,the USER and their respective successors and assigns.
USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or
specifications,to include utilities locate requirements and use limitations/requirements of easements, public right-
of-ways and other public land. USER further agrees that the CITY and its officers and employees shall be saved
harmless by the USER from any of the work herein under the terms of this permit and that all of said liabilities are
hereby assumed by the USER.
GL.1 CA Date ,/
e2/2a2,3
Property Owner/Agent( igned in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL I
pTheforegoinginstrumentwasacknowledgedthis222\u
day of "`"[ v)i b r 20 23
by '3"-ur e wa Or). Sc5ctie,.t printed name of Signer),who personally appeared
before me and acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
k,4."•4! `,VANESSA ANGERS
MY COMMISSION#HH 244118
EXPIRES:March 23,2026
Department Approval:
Signatu Notary ublic, State of Florida
Per onally Known
Oroduced Identification(Type)FL. ))t.— Public Works Department Date
Revision Date:05/09/2023