63 Coral St DWAY24-0004 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
COLLINS PEGGY L 63 CORAL ST ATLANTIC BEACH FL 32233-5815
COMPANY:ADDRESS:CITY:STATE:ZIP:
WRENN LANDSCAPE
DESIGN LLC 584 34th STREET JACKSONVILLE
BEACH FL 32250
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169594 0170 OCEAN GROVE UNIT 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
63 CORAL ST DRIVEWAY SINGLE OR TWO
FAMILY DRIVEWAY PAVER DRIVEWAY $10000.00
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 UTILITIES METER BOX SEWER CLEAN OUT INFORMATIONAL
Notes:
Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible.
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 3Issued Date: 1/24/2024
PERMIT NUMBER
DWAY24-0004
ISSUED: 1/24/2024
EXPIRES: 7/22/2024
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
3 PUBLIC UTILITIES ADDITIONAL COMMENTS PUBLIC UTILITIES INFORMATIONAL
Notes:
See Revocable Encroachment Agreement regarding driveways/pavers and public utilities in the ROW
4 PUBLIC WORKS DRIVEWAY APRON INFORMATIONAL
Notes:
All concrete driveway aprons must be 5 inches thick, 4000 psi, with fibermesh from edge of pavement to the property line. Reinforcing rods or mesh are
not allowed in the City right-of-way.
5 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.
6 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.
7 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
8 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.
9 PUBLIC WORKS SLAB DRIVEWAY REMOVAL INFORMATIONAL
Notes:
Slab and driveway to be fully removed.
10 PUBLIC WORKS MAXIMUM DRIVEWAY INFORMATIONAL
Notes:
Maximum driveway width within the City right-of-way is 20 feet.
11 PUBLIC WORKS GRASS INFORMATIONAL
Notes:
Full site to be grassed.
12 PUBLIC WORKS REVISION INFORMATIONAL
Notes:
Any plan change must be submitted as a Revision to the Building Department.
13 PUBLIC WORKS DEBRIS REMOVED INFORMATIONAL
Notes:
All construction debris must be removed from job site by Contractor/Owner.
2 of 3Issued Date: 1/24/2024
PERMIT NUMBER
DWAY24-0004
ISSUED: 1/24/2024
EXPIRES: 7/22/2024
DRIVEWAY 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
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00
TOTAL: $150.00
14 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor/Owner.
15 PUBLIC WORKS IMPERVIOUS AREA INFORMATIONAL
Notes:
Replace existing driveway only. No additional impervious square footage area can be added to this property.
3 of 3Issued Date: 1/24/2024
PERMIT NUMBER
DWAY24-0004
ISSUED: 1/24/2024
EXPIRES: 7/22/2024
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Final Plumbing
Final Electrical
Final HVAC
CC Final
Final Building*
Swimming Pool Steel
Swimming Pool Safety
Electrical Grounding & Bonding
Swimming Pool Final (Bldg)
Swimming Pool Final (PW)
Formed Columns/ Beams*
Masonry Cell Fill
Structural Steel*
OTHER:
OTHER:
OTHER:
OTHER:
OTHER:
Power Pole
Silt Fence
Piers/ Stem Walls
Underground Plumbing
Underground Electric
Foundation/ Footing
Slab**
Retaining Wall Footing
Driveway
Sewer (Building Dept)
Sewer Tap (Utilities Dept)
Rough Electric*
Rough Plumbing/ Top Out*
Rough Mechanical*
House Wrap
Wall Sheathing
Roof Sheathing
Tie-down Framing Connections
Rough Framing
Roofing In Progress
Window/Door In-Progress
Insulation Ceiling
Insulation Wall
Exterior Lath
Stucco Scratch Coat
Exterior Siding In-Progress
Brick Flashing & Ties
Early Power
Gas Rough
Gas Final*
* When all rough electric, plumbing, mechanical are complete but before any work is
covered up.
* When all gas piping is complete and wallboard is installed but before gas is
attached to any appliance. All outlets must be capped and pipe pressurized at a
minimum of 15 lbs.
* For new living space: When all construction work including electrical, plumbing,
mechanical, exterior finish, grading, required paving and landscaping is complete
and the building is ready for occupancy, but before being occupied
Additional inspections may apply to your project if your project
contains these elements:
INSPECTIONS REQUIRED FOR BUILDING PERMITS
To verify compliance with building codes, inspections of the work authorized are required at various points of the construction.
The following inspections are typically required for residential projects:
Date: Initial: Date: Initial:
_____________________________________________________
Permit Type
____________________________________________________
Permit No.
__________________________________________________________
Job Address
____________________________________________________
Contractor
POST THIS CARD WITH PERMITS AND PERMIT
DOCUMENTATION IN FRONT OF BUILDING
Construction Hours per City Code: 7am—7pm Weekdays; 9am—7pm Weekends
Building Department Public Works/Utilities Fire Department
Phone: 904-247-5826 Phone: 904-247-5834 Phone: 904-630-4789
Fax: 904-247-5845 Fax: 904-247-5843 Fax: 904-630-4203
* When forms and reinforcing steel, anchor bolts, sleeves and inserts, and all
electrical, plumbing and mechanical work is in place, but before concrete is poured.
* When all structural steel members are in place and all connections are complete,
but before such work is covered or concealed.
** FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION
PAVER DRIVEWAY
63 CORAL ST
WRENN LANDSCAPE DESIGN LLC
DWAY24-0004
BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE
IONLY
i"City of Atlantic Beach Building Department PERMIT#w l ZZl_
y 800 Seminole Road, Atlantic Beach, FL 32233
ALL information required to process
fll Phone: (904) 247-5826 Email:Building-Dept@coab.us
Job Address ‘S (rytJ St • RE#
Legal Description L6AA,LOrD UL VA,* No. 1_,. block- q
Valuation of Work(Replacement Cost) f moo Heated/Cooled SF Non-Heated/Cooled SF
Class of Work: New Addition Alteration 'Repair Move Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial Residential • If existing structure, is a fire sprinkler system installed?:Yes No
Will tree(s)be removed in association with proposed project? Yes (Must submit separate Tree Removal Permit) No
Describe in detail the type of work to be performed:
J'L CC,n ej-la ,d vt v'Q.CC9- t"! V Q 5 - `(LC—VIAL uti.—L--
Florida Product Approval# For multiple products use Product Appr val Information Sheet)
Property Owner Information Name paq au( Phone tg -
Address J C City Ty State Zip 32z3_3
Email O, +1 i 1;1 A 1e tar g/1 shit(If Agent, Power of Attorney or Agency Letter Required)
ContractorrInformation Name of Company WfTi 0 C fid _ Ty I j1.e.Phone >011, i i 4_. Lf 151
Address 5 y S/I City j State ('. Zip 32 Q
Qualifying Agent pN R . N -T State Certification/Registration#
Email ..« .:=e';.%.,1d:.'01...misi.w, Job Site Contact Number 'kg-, +2-• I4(5I
Worker's Compensation Insurer kY
J
OR Exempt ' Expiration Date
Architect's Name Email Phone
Engineer's Name Email Phone
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 city/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 YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT
MUST BE RECORDED AND POSTED ON THE SITE OF THE IMPROVEMENT BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Cka_____________
Signature of Owner or Agent) Signature of Contractor)
Signed and sworn to(or affirmed)before me this 2_,14---,. day of Si ned and sworn to(or- firmed)before m- this i day of
1)Q I , 71)93 by TOL y t. Lp tn 1 5 cam P a by'_//i. r
J -(
Signature of Notary 1 9 t,SL(.An iLt Signature of Notary 4 "
I ] Personally Known R IX] Produced Identification I Personally Known OR [ ] Produced I.'enti ication
Type of Identification: FL .L ex, 11 r 20 Type of Identification: H •_
s :'4'?;'"..• .F ERJOLA DURMISHI TONI GINDLESPERGER
Commission#HH 270865 MY COMMISSION#HH 407122
fij•••br: ExpresJune 4,2028 r.,:
EXPIRES:October 6,2027TFOFFSO..
Owner Builder Affidavit ALL INFORMATION
HIGHLIGHTED IN
City 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#:
I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES
OWNER/ BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED
FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU, AS THE OWNER
OF YOUR PROPERTY, TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A
LICENSE.
YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF.
YOU MAY BUILD OR IMPROVE A ONE OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY
ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS.
THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE
I CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH
IS IN VIOLATION OF THIS EXEMPTION.
YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS.
IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES
REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES.
II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT
SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. .
III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING
TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT
TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE
OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CERTIFICATE"TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT (904-
247-5826 OR BUILDING-DEPT@COAB.US ) IF IN DOUBT.
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I
COMPLY WITH ALL, THEREQUIREMENTSFOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
Job Address: ) t t i .
Owner Name: ft.//1 , 't l it S Phone Number: )n'-f',rj 6-7-'
Mailing Address:rd( City: t ' iQ kgie, iv C l State: ft Zip: 3Z2-33
Notarized Signature of Owner
The foregoing nstrument was acknowledged before me this day of CL'wL), , 2023, in the State of Florida, County
of .1\A.0 i-
Signature of Notary Public u 99 ,Dc,S--,k2 ,
i ] Personally Known OR l* ] Produceeddd Identification
Type of Identification: FL L\L rxi // Zg
EYP '
ERJOLADURMISHI Updated 10/24/18
Commission#HH 270865
r' Expires June 4,2026JFF. :
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NOT VALID UNLESS EMBOSSED KITH SEAL OF THE UNDERSIGNED. I
11#'PROPERTY SHOW HEREON APPEARS TO LIE NITHIN 11000 HAZARD ZONE X IAS SCALED FROM FLOOD
1I JRANCE RATE
MAP1 . /
FOR 7HE CITY OF JACKSONVILLE FLORIDA, DATED 4-/7-8') . AND
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SH• OW ASAA COURTESY ONLY ANDI DOES NOT CONSTITUTE A CERTTFCATTON OF SAME.
I 1 I i
1 ie a MEADOWS
STATE LANDJACKSONVILLE,SURVEYAORS INC.
731-7235
LEGEND S.. ----- -1 THIS-SURVEY DOES NOT REFLECT OR DETERMINE.OWNERSHIP.
ca''''•°' j NOT VALID WTTT1OUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL
ACM_R. II OF A FLORIDA `LICENSED SURVEYOR AND MAPPER. •
Sr1 7H Olf I LS OW) `
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CUIWILOIL 46
AA RR cvanora Mo EGISTER.D 'ERIIYYJR ANDCAPPER,
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F.B. 404 PG. rel l ORDER N0. 95-47&,F
IJ,•. REVOCABLE ENCROACHMENT AGREEMENT
1800 City of Atlantic Beach
ALL INFORMATION
HIGHLIGHTED IN GRAY
Seminole Road,Atlantic Beach,FL 32233
IS REQUIRED.
REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation organized and
existing under the laws of the State of Florida, hereinafter referred to as"CITY" and
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 /-4-6rllu Afai1 Xr) .q &frit a,,,Er
w,o-/t iT-2,&tj
Any facility maintained, repaired, erected, and/or (nstalled in tile exercise of the privilege granted remains subject to
relocation or removal on thirty(30)days' notice by CITY to USER,said notice to USER shall be given by certified mail,return
receipt requested,to the following address
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
ere y assumed by the USER.
202.4XDate02. Q g
Property Owner/Agent(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this day of lstvt 20 2_x-1 ,
X by re/ 4h L, (_ 1 \V f printed name of Signer),who personally appeared
before me and acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
4""1. :•; ERJOLADURMISHI
j•: 44' •Commiss on#HH 270865
1 ••••Expires June 4,2028OFiP:
OV a Department Approval:
Signatdre of Notary Public, State of Florida
Personally Known
A Produced Identification(Type) I )112 Public Works Department Date
Revision Date:05/09/2023
RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION ALL INFORMATION
f--.-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 43 COrtti Sf. Permit Number
Contractor Information
Company r cam - C. ' Qualifying Agent /dJ/ li. -t- I Lt/4-_,
Address SBX 3y 711 ,,Th/ S. City J/})! jc_/f StateZip 322)0tka
Phone 620 4/- L/2 `/- Y/ 1 Email 1:4/,•.14,1„,,,,.,Y T- uT
State Certification/Registration #Y3:3 7 C7 3 (1q
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 performed 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 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 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.
P blic Works Director shall be notified 24 hours prior to starting work and again immediately upon completion.
J Date Y0-4 o j, Q
Permittee(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
rr.4\'‘
eThe
foregoing instrument wasacknowledged this CJ day of n.&p_ 20 1Li
X by
Li
L, l,0'1. ,/1 5
J who personally appeared before me and
printed name of Permittee)
acknowledged that he/she signed the inst R twewt.TJl d in it.
o`"",. ERJOLADURMISHI
y Commission#HH 270865
C_S 0'9) C \AM(A ":`—" : Expires June 4,2026fa` . Pers nally Known
L f `IISignator@ofNotaryPublic,State of Floridaw.. ced Identification (Type)Fc
H:\Applications&Forms\Word&Excel Document Originals\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18
NOTICE OF COMMENCEMENT
State ofTax Folio No.
County of Oil
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713
of the Florida Statutes,the following information is at in this NOTICE OX COMMENCEMENItrLegalDescriptionofpropertybeingimproved: 0(11 Q'hl– '21'ove Lt ibtbeL 2
Address of property being improved: la?' U 1 0..l_ Mt
General description of improvements: rep lace- l:fmu e, d r) V p a Vevs
Owner:1,DL 03 Address: (23 aP ( '
I . (
r14 Mi •
Owner's interest in site of the improvement: Gl',.+"Y1I01-0
Fee Simple Titleholder(if other than owner):
Name:
J
Contractor: (A)'(-Pir1 n -.`
pp` •
Q{t('..
0
Address: a4. C 52
Telephone No l0 t. (47,4: if ICJ Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of an person making a loan for the construction of the improvements
Name: ('t'
Address:
Phone No:Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may
be served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a differe •a • •is.,
S•,_ 9:
specified):p_.•:`;
THIS SPACE FOR RECORDER'S USE ONLY OWNER
f
gSigned: Date: /L-2 t O
Doc#2024005521,OR BK 20918 Page 663, Before me this day of e - ' in t/ County of Duval St lie o
Number Pages: 1 Of Florida,has personally appeared Se.• ' , c
Recorded 01/10/2024 01:01 PM,
Notary Public at Large,State of lorida,Coun of D uval.
P. _
JODY PHILLIPS CLERK CIRCUIT COURT DUVAL OZ
rn
COUNTY My commission expires: = ` –
RECORDING $10.00 Personally Known: 1
Produced Identification: FL A L eke I£1 Z'
Existing pervious/
landscaped areas cannot
be paved and must
remain pervious.