Permit 1765 Beach Avenue ,1-J)Lj\
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J ATLANTIC BEACH,FL 32233
19 INSPECTION PHONE LINE 247-5826
Application Number 09-00001427
Property Address Date 3/15/10
1765 BEACH AVE
Application type description RIGHT-OF-WAY PERMIT
Property Zoning . . . . . . . TO BE UPDATED
-----Application-valuation . .
0
-
Application desc-------------------------------------------------------
CONCRETE TO PAVERS DRIVEWAY
---------------------jOWNER
Owner
___ _
--
PAYNE 1765 BEACH AVE ATLANTIC BEACH FL 32233
-------------- ------------ --------------
Permit -- ---J--
Additional
. DRIVEWAY PERMIT
desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee
Issue Date . 00
9/11/10
Expiration Date . . Valuation 0
------------------------------------------------------
Special Notes and Comments
Ensure all meter boxes, sewer cleanouts and valve covers
are set to grade and visible.
A sewer cleanout must be installed at the property line .
Cleanout must be covered with an RT1 concrete box with
metal lid. Cleanout to be set to grade and visible .
All sand must be removed from Beach Avenue daily.
Cannot block traffic flow on Beach Avenue .
Roll off container company must be on City approved list
------ -
------and cannot be placed on City right-of-way.
---------------------- ________
------------
Fee summary Charged -------
g Paid Credited Due
----------
ermit Fee Total 35 . 00 35 . 00
Plan Check Total . 00 . 00 . 00
Grand Total 35 . 00 35 . 00 . 00
00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC
BEACH
Budding Department
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
PHONE 247-5826
February 10,2010
River City Pavers Creations, Inc.
524 St. Johns Bluff Road North
Jacksonville, Florida
RE: PERMIT FEES DUE—PAVER DRIVEWAY
1765 BEACH AVENUE,ATLANTIC BEACH,FLORIDA
Dear Mr. Jimenez:
On October 23,2009, a permit application was approved for the installation of brick pavers at 1765
Beach Avenue,Atlantic Beach,Florida. As of this date the permit fee of thirty five($35.00)dollars
has not been paid as required.
In addition,an inspection of the premises reveals the pavers have been installed. I have made several
attempts to contact you by telephone and have not been successful.
Please return the enclosed invoice with your payment offive $35.00
Atlantic Beach within five(5)days of the receipt of this no ce. ( ) yule t°the City of
Should you have any questions relative to this matter,please feel free to contact me at(904)247-5826.
S' cerely,
k"('I�>�' �
Debbie White,Permit Coordinator
Attachment 0 b- 4
vJ
Cc: Seth and Brandi Payne, Property Owners
� � 1
� �ti
PREPARED 10/23/09, 13 : 31 : 52
CITY OF ATLANTIC BEACH PAYMENTS DUE RECEIPT
-------------------------------.- PROGRAM BP820L
----------------
APPLICATION NUMBER: 09-00001427 1765 BEACH AVE---------------------------
FEE DESCRIPTION AMOUNT DUE
-----------------------------
DRIVEWAY PERMIT 35 . 00
TOTAL DUE 35 . 00
Please present this receipt to the cashier with full payment .
I (U ?, -
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Oct 13 09 01 : 44p
p. 1
R.O.W. Permit Attachment
of for
R.O.W. Permit# issued , 200_ Atlantic Beach, FL 32233
Owner's Name: (SETH -t LI I N D i I r)*QFF
Property Address:
ATP-4 &BCH FL
Subdivision:
Lot#/Block#:
R.E. #:
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this
day of
200, by 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 of the City of Atlantic Beach for the purpose as described in the City of
Atlantic Beach Right-of Way/Easement permit numbers noted above (copies attached).
This work is generally described as: _jfI E t4-660VF1 L O TI-1 t- UX `';f7 N t,
C°QN C Y-t _717 L -►V FtAA J l-WTtiv I I Ft A l(-r#V P 11T CSE
Ill Dlt)U'1•-cyoy --
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 the USER, said notice to
USFR shall be given by certified mail, return receipt requested, to the following address:
The depositing of said notice of cancellation in the United States mail shall constitute the notice of
cancellation and the burden is upon USER to keep the CITY informed of USER'S proper address.
The USER shall promptly make any and all necessary repairs to any facility erected or maintained in
the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe
condition.
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 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."
Page 1 of 2
Oct 13 03 01 : 44p
p. 2
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. The
USER shall, at the discretion of the CITY, be requested to submit as-built drawingsshowing the change
within thirty(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.
USF,R 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
fficers
public rights-of-way and other public land. USER further agrees that the CITY and its oand
employees shall be saved harmless by the USER from any of the work herein under the terms of this
pen-nit and that all of said liabilities are hereby assumed by the USER.
DATED and SIGNED this lw-'q day of ()C"T(J 1�,E- - , 2009
t
By:
Property Owner
(to be signed in present of.the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this day of 2011 rsonall a
Public in and for said County and State, Y appeared before me, a Notary
�� a.�-I' r� � � the properly owner of
Atlantic Beach, Florid , known to me to be the person(s)
(described in and who executed the foregoing
executed the same freely and voluntarily adfor theusesand Purposes therein mentioned. gat he ar she
ublx fo aid County and State ;bt' Y^LB,.,,� SARAH M.:DD
MON^
+* .i : Notary Public-Sof Florida
•:My Commission ExpJun 28,2010
Y OFA AN IC BEACH, FLORIDA, a '.��� �:' Commission# 569312
t icipal co ion; " Bonded By Nationotary Assn.
Approved:
Ricky L. atper,Public Works Director
For Permits where city sidewalk is impacted,
City Manager approval required:
Jim Hanson, City Manager
Page 2 of 2
10/19/'09 MON 10:56
9
r 192475845 1/ i
Cmr OF ATLANMC
iSeeCON
STRUCTION PERM r W TH N CITY Rlr.&r OF WAY AND EASEMEttJTS
800 8*M'"li Rood
Athnaa such,Florida 32233.x446 904.3474id
'LlASE eiUBMtT(a)COMPLETE SMG OF PLAN$WITH APPUCA7I01N. Fax vox,a.7.saos
�ate`„jD 1? Z Obi
lob Address Pt:RtyNrs
/C &MCH ISSUIED 81rTHR c"y
'@RTtIFCe: —��V�ZC/riJ �'/91l� ��7'/dt+1lS n/C
Telephone* 14100 V yy--$9S U
'OrMItI Addross: 57-YO-
Y • )OHtbS ,g
e /uPr- ALO Al. , i
lequestin Pw lssbn b Construct: gjeQ' 1$r //�/
c E W .►'
ocs>don, (Reference to Cross-Street) 12,�Cf}
1. Applicant declass that prior to filing this a pPilcetipn
both earial and unt'pround and the accurate do he has ascertained the locution of all exiallng utlllues,
A Letter of Not)f�atton was mailed to the looaltons are sham an the sketctlaa.
following tJtillties/Munioipe{hies;
.Iacksornllle Etsotrio Authority
Bell South Telephone Company Ym( ) No ()K) Data.
Farrell One Yes( ) No (K) Data:
Comcast Y+s( ) No (x) Data:
Yea( ) No (t() Date:
2. Whenever necessary for the construction, repair. Im
ailar"On or raloceWn of ail,or an R1e^t. 1`110 enence, sells and efficient operatfon,
Works,
any or all of Said y portion of said sheet or eastrment as determined by the Director of Pubk
hd appurtananOss authorized
arounder, Shoff be immadb talromovedpfrom� said street ocables or r�esaasmant or r facilltim nnos or nab tied horeon as
required by tete Director of Public works, and at the expense of the PWMRbaa unless reimbursement is
authoMsed.
3 All work shall malt Clty of Atlantic Beech or Florlde Depertxrtent of 7ransportetlon Smndatds and be
performed under the Sup�!ision of �Ibt/E� .18 E)Gp E*L
Suparin0endanq bcatad at 1765 13w —r:...,4 (Cg1cWe s Pr -eat
4. All n+atariais and equipment Telephone fir.(
«i pmanr malt be subject to inspsctlon by the Director of Public Works or h(s deat�e�
S.
All sty property shall be rostered c ib original condttlOn as fair as practical,in keeping wish city spedflcatimm
and tiro manner satisfactory to the city.
L A sketch of pians covering details of this Installation, as
Pm ofonepermitIneswell as. a copy Of a recent survey shall be sada a
�� C i
e with t 101LAILhalAty
7. Tho Permnbee WNR commlanoe actual construction in good faith with�_days. If the beginning date is
more then f days from dobe of permit approvel, then permittee must review the permit with the Dit>iotor of
Public Works to mefw sura na changes have axunacf>n the area that would affect the
B. It Is understood and agreed(hat the rights and pttvil _ twitted construction.
City's tight, UVG and inter�at in the land a0 to entered UPOn and used y the hrolder, and ythe Holler wig, at ato the extent of ll
times, assume all risk of and indemnify, defend, and ettve harmless the City of Adaptic Basch from and
against any and all lose, dama,ggee, and cost of expenses arising M any manner of the eacer�cise c from and
exercises by the holder of the aforesaid tights and privileges.
g• The Dlr�actor of Public Works shall be notified twenty-four (24) houm prior to stmrting work and again
Immediately upon completion_
OWNER
Monad: t)eb- i a /R/of 1OBSITE COPY
Skits Of F thw day of h the county at OWai,
bride.has PmsonNly appeared
Notary Pubaa at tarps,Biala oligirlda,Coan o 1.
My cmunksien swiea:
Panenaay Known!
uad Idenerlostion:
d 9685-1tiZ-606 O "DaureiaAg uonsurjojui d
6Z.E0 60 EL p0
. ..... ......... .._..._ _ _ _
r _'^ CITY OF ATLANTIC BEACH
4 rl" Building Department
f`t 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
PHONE 247-5826
February , 2010
jojj
Riv rCiPavers Creations, Inc. - - -�/
6 t C�U
St. Johns Bluff Road North
4bU
Jacksonville, Florida 37i �
RE: PERMIT FEES DUE—PAVER DRIVEWAY
1765 BEACH AVENUE,ATLANTIC BEACH,FLORIDA
Dear Mr. Jimenez:
On October 23,2009,a permit application was approved for the installation of brick pavers at 1765
Beach Avenue,Atlantic Beach,Florida. As of this date the permit fee of thirty five($35.00)dollars
has not been paid as required.
In addition,an inspection of the premises reveals the pavers have been installed. I have made several
attempts to contact you by telephone and have not been successful.
Please return the enclosed invoice with your payment of thirty five($35.00)payable to the City of
Atlantic Beach within five(5)days of the receipt of this notice.
Should you have any questions relative to this matter,please feel free to contact me at(904)247-5826.
Sincerely,
Debbie White,Permit Coordinator
Attachment
Cc: Seth and Brandi Payne,Property Owners
/-010
J v�
10/19/109 NON 10:56 )92475845 i/ 1
r '
Og
`� r lyi?
CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
1•
yr 400 asmlllols 9W-01+174100
Artsa09 010906,Fbdds 32233.4446 Fax NW247-SW
•ZASK EUBMir ta)COMPLETE SETS OF PLANS vinTH APPLICATION.
me-jALWMI e
bb Address l 7bS ibeefaH 4VE LL-ANUS. Gift-tH I
ISSUED my TME car
�ermlise• __1 y%ciTN r'/9t/E#zL,_Cg011ays /NG Telephone# f i0t ry)
larmUn Address: S Z-Y -o• J OIM S 8 UPP "o N- siA-e P-savvy e c V a
tsquest�Yl nis�on b conatn�c�� Whom' �'jCrSY`fnf ry C�ll�ic- 1'E jw!�!! ^4►9y �-
C IF fret PrH P e%^ -
,acadan: (Reforonos to Cross-Strest) e2e"RA A V% 6V7WfAN 1TH ZZL
1. Apptksurt declares that prior to filing this application he has sacertatned the bc0on of aN erdOW utllltiss.
both sarlal and underground and the accurate 1908WM ate shown on the sketches.
A Letter of Notification was mailed b the following UtilidesNunicipaltUes:
.iackwnWpe Electric Autluxity Yee( ) No (►r) Dates
Bell South Telephone Company Yes( } No (K) Data:
Ferrell Gas Yes( ) No (tx) Dab.
Cvmcstst Yes( } No (if) Date:
2. Whenever necessary Ilor the construodon, repair. improvernent, maiMennnce, Bob and ellident 01)100000n,
alteradon or relocation of all,or any portion of said street or comment as determined by the Director of Public
VVbrks. arty or all of avid poliw wines. pipes, cables or either faclWas and appunteneness suth0rttoed
hereunder, shall be krnnedtately removed from said street or onament or reset or relocated hereon as
requited by the Director of Public works, and at the expense of the Penrifte unless re&nburs■merlt is
authorized.
3. All work shod meet City of Atlantic Beach or Florida Departrrterlt of Transportation Standards and be
parfomwel under the suporviabn of M16 Q J/M4gV WL —Jcwwmws P 'ed
supellronde"10-11 1-1 d at 7k� G____HC - TeMphalne t-•
4. All materials and equipment shall be subod In Inspectlon by the Oinctm of PUNIC Works or his deahgnee.
S. All city property shell be restored tb its original condition as tar as pracbcal, in keeping with dty e10e00111100tim
and the rnarnner satisfactory to On eihr.
a. A sketch of pl rm covering duels of this I stal►saon. in well as. a copy of a recent survey she/ e
be mw a
part of tMa pw miL Camel gl w i......r.n any la the ck_ v_
Right of Watt are Ig be included wish tlria aodtcatlt,n.
7. Tht4 pe m""*MR c mintohh adual const uallon In good bNh with 10_days. If the beginning date is
more then so days fran dab of permit approval, than pamaillee must review the permit with the Dftotor of
Public Works to make sure no changes have occurred In the ares that would aftaet the permitted oofteO Ion.
B. It is understood and agreed"the rights and P*400e9 herein set vut arta granted onht to the extent of the
City's right. tlW and Interest In the land ito to enVxud upon and eked by this holder and the Holder vrll, at all
times, assume all risk of and Indemnify, defend, and save harmless tete City of Atlantic Beach Brom and
against any and all loss, damage, and cost of expenses wi tg lo any manner exercise or aNempted
exerchrea by the holder of fire aforesaid rigtlts and privileges.
9. The Dfrector of Public Works shah be no~ twenty-four (24) hours prior In
ImmadW y upon completion. r
OWNER
Stoned: Dds:
eNom me thio day --In the CauM1►of MwL
Slobs Of Florida.hes porsadly appear 9d
Nubry PubW at Largo,able of Fiends,Cean
MY commission sxptas: Par,on0N1
used IdstWkwdw: COP,
I,-d 3t+89-&Z-006 0 AllosmIsAS uop"o)ul to 60 91, ISO
Oct X13 03 O 1 : 44p i/ P. 1
R.O.W.Permit Attachment of for
R.O.W. Permit* issued ,200_ Atlantic Beach,FL 32233
Owner's Name: se-rk -' AX-A NO i NINE
Property Address: 1205 b e fCH AF
A:7_t C AE Cit Ft_
Subdivision:
Lot#/Block#:
R.E. #:
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
200_, by 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 of the City of Atlantic Beach for the purpose as described in the City of
Atlantic Beach Right-of-Way/Easement permit numbers noted above(copies attached).
This work is generally described as: 7W F tZt-A 0Vft 4l✓ T74 6:- G-X ISW N t'1
CON C Vt`r- D i EW41
IJy b1�-14� .sy
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 the USER, said notice to
USER shall he given by certified mail, return receipt requested, to the following address:
The depositing of said notice of cancellation in the United States mail shall constitute the notice of
cancellation and the burden is upon USER to keep the CITY informed of USEW s proper address.
The USER shall promptly make any and all necessary repairs to any facility erected or maintained in
the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe
condition.
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 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 pen-nit 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 (11) 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."
Page 1 of 2
Oct 13 09 01 : 44p p. 2
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. The
USER.shall, at the discretion of the CITY, be requested to submit as-built drawings showing the change
within thirty(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
public rights-of-way 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-
DATED
SERDATED and SIGNED this ,17T0 day of OCTO ,200
,1
C
By: �
It
Property Owner
(to be signed in presen of Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this 1SIL_ day of 204rsonally appeared before me, a Notary
Public in and for said County and Stmate 1A A I f il..0 the property owner of
(jam 33 4 34) 1% oAtlantic Beach, Floridk known to me to be the person(s)
"-described in and who executed the foregoing instrument; who acknow edgedto me that he or she
executed the same freely and voluntarily and for the uses and purposes therein mentioned.
,,..•�P,,,� SARAH M.SALMON-
ubl>i ' f aid County and State''" ;w Notary Pubk-state a Flalda
• y Cwz6sion Expires Jun 28,2010
Y OFA C BEACH,FLORIDA,a %;,a '� � j #DD 5693!2
Bonded By National Notary Assn,
L 'cipal co ion:
pproved:
Ricky L. Carper,Public Works Director
For Permits where city sidewalk is impacted,
City Manager approval required:
Jim Hanson,City Manager
Page 2 of 2
4
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VI
COASTAL CONS7RUC7100V CONTROL UNE
COAST
GENEF
O/R I
LOT a
CONC. BLOCK FOUNDATION
/1769
(F.F.£20.68)
20.6'
E 530 8217 �6 a o N89'"1W 09 7.00'
AM r � � 2b17 Q? NPaw PIPE wAMaN PMpE
v 7 LK
BRIM PAMPERS
42.5' COV.
1� 36.8' BRKa1C 13.6'
1� � o. 9
g 2 STORY STUCCO
BASEMENT GARAGE � o
Fir. GARA(JE r5.06'I.CT n One 21 28, `" A c O
F.F. 2ND FLOOR 3278'
d0 ;/7765
35.3'
34. ' a WOODSI£PS TIL£d i
(� 0 � 29.8'
�1 P
EV AC
n 18.81 P1ll.E
MD POOL 4' WO
9ADIItR
TIL£COW
COV. SUAA(fR F
N. 2185832006 ✓AC
E. 530715.000 CONC.
SF1ED QQNCR£lE PA
V£RS
BENCHMARK s, O' aSa�'O9 209.88 �►
SET x-CU>'IMI CaVa 6.3' ��' � N 2W67'MOV PIPE ID IIOm PIPE' Cl
ElEK-I LM
EASEMENT FOR 1 & 2 5 rr
INGRESS AND
EGRESS` PER ORV 529,
C3 PAGE 120, LOT 32
tr
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CR'
V
ED
City of Atlantic Beach OCT Z �9 APPLICATION NUMBER
a � Building Department (To be assigned by the Building Department)
)
: 800 Seminole Road A.
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review required Yes No
Building
Applicant: 10IA)A[4e— Planning &Zoning
T trator
Project: 6negeri- , ��R✓£�S ublic Wor
u is Utilities
r r t/�.c��� a ety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: [Approved. ❑Denied.
(Circle one.) Comments: /P ��ti, s J— �-c 1&�ill r4►� C� ("'t" J�
BUILDING i,Q. 1) Cr ��v�� '�/ '''C / d1,� lieb">--
PLANNING &ZONING P �� 12c`�/�Q��
Reviewed by: Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05114109
City of Atlantic Beach APPLICATION NUMBER
H Building Department (To be assigned by the Building Department:)
800 Seminole Road O 2.-
a
..
Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
t. Date routed: ,2 G O _
E-mail: building-dept@coab.us
City web-site: htt :Ihmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: f��. f A/y� AV_ Departinent review required Yes No
Building
Applicant: Q(,�/{l2. Planning&Zoning
T ttator
Project 6nA �R✓£�S ublic Wo
u tc Utilities
Fire Services
� � K
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida DepL of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Dimision of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other.
APPLICATION STATUS
Reviewing Department First Review: pproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by: Date:
TREE ADMIN. Second Review:
Approved as revised. FlDenied.
AU
O S Comments:
S
Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05114109