309 PLAZA ACC23-0002 - Revision revocable encroachment 7-17-23Revision Request/Correction to Comments
City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL32233
Phone : (904) 247 -5826 Email : Bu i ld i ne-De pt@ coa b. us
.IAII.INFORMATION
HIGHTIGHTED IN
GRAY IS REQUIRED.
ccPERMIT f:
l-l Revision to lssued Permit OR p Correaions to Comments
contact phone: Qf -k ^ aa Emair: ? I
fn ' * r
Project Address:
Contractor/Contact Na me:*ta
Description of Proposed Revision / Corrections:tre 4e
lrt os l/a)?TW
affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
o Will proposed revision/corrections add additionalsquare footage to original submittal?
Ffrfo E ves (additionals.f. to be added:
. Will proposed revision/corrections add additional increase in building value to original submittal?pho fl*Yes (additionalincrease in building (Contractor must slgn if increase ln valuation)
'Signatu re of Contractor/
! approved D oenied
(Office Use Onty)
! not Appticable to Department Permit Fee Due S
Revision/Plan Review
Department Review Required:
Building
Planning & Zoning
Tree Administrator
Public Works
Public Utilities
Public Safety
Fire Services
Reviewed By
Date
uNoted 20/17/t8
By vangers at 12:48 pm, Jul 17, 2023JOB COPY
i
REVOCABIC ENCROACHMENT AGREEMENT
Clty of Atlantlc Beach
E{Xl Semlnole Roa4 Adandc 8€ach, Ft 32233
RryOGAgl,E ENCROACHMEiITAGREEMENT bythe Cityof Atlantic Beach, Florlda, a municlpal corporation organized and
existi the laws of State of referred lo as'ClTlt and
of Atlantic Beach, Florlda, herelnafter
to as'USER".
WM{ESSETH
That the OTy does hereby grant the USER permlsslon on a revocabh basis as described herein the rlght to enter upon the
property forthe purpose as described in the Gty of Atlantlc Beach'
This wo* is generally descrlbed as
Any facility maintained, repalred, erccted, and/ot installed exercise of the gnhted remains subject to
relocation or removal on thirty (301days'nothe crY noticeto USER shallbe given bY mall return
receipt requested, to the following address
o tn the event it !s necessary for the OTY or the Cit1/s approred representative or other franchised utillty to enter
upon the above descrlbed easement or property of the clw, the usER shall replace at the uSER',s sole expense,
any and all material necessadly dlsptaced during the action of malntainir6 repairing opeftltin& rcphclng or adding
to of the utllitles and facillties of the CITY or franchlse utility prwider.
r Tlle fadltties allowed by the permit shall meet the current requlrements of the Crty Code EuiHlng Codes, tand
Darelopment code and alt other hnd use and ode requirements of the C!TV, lncluding Gty Code Section 19'7(h)
whldt states ,Driveways that cross sldewalks: crty sldewatks may not be replaced with other materials, but must
be rephced with srnooth ooncrete left natural in colorso that it matches the existing and adjoining sidewalks.'
o The USER, prbr to maklq any change from the approrrcd plam and/or tnethod, must obtaln written approral
from the City of Atlanilc Beach public Work Department, for sald change within 30 days after the dav of .
oompletlon.o This permit shall inure to the benetrt of, and be blndlng upon, the uSER and thelr nespectlve suessors and assEns.
o USER shall meet the terms and conditlons of thls permlt and to all of the applkabk State and Cfi hws and/or . ..'.'
specifications, to lnclude utiliths locate requircments and use limitatlons/requirements of easements, publlc rlght' :
of-wavs and other grblh land. USER funher agrees that the OTY and tts ofFrcers and employees shall be sated
harmleas by the t SER from any of the work herein under the terms of this permit and that all of sald liabllities arc
bvthe us€R.
(slgnd ln presence of Notary Publlc)
SrArE OF nOnDA, COUitrY OF Dt VAt
The foregolry instrument was acknowledged thtr
bv
before me and adnowledged
of Florlda
!' -Hioao.t!:c/osl203
?.?
*vor@20GF''
(printed name of Signer), who personalty appeared
forthe purpos€ exPressed ln it.
Departmcnt APPmval:
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I
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of
Gtt6tltPlufrllolryR!ilc-tl&o,fb.l(,r
Cqmldst t tlll ltctltIt Cdlll. tpt.' ln lt, lolt
llrcr8h Xrbod xoutt f!.tr.
$'',F.A T0/V{4J L(o Publk Works tlePartment Date
JOB COPY