Permit R/W 5th StreetCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
Application Number 09-00000819 Date 6/11/09
Property Address 5TH ST
Application type description RIGHT-OF-WAY PERMIT
Property Zoning TO BE UPDATED
Application valuation 0
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Application desc
repair improve tele cable
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Owner
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Contractor
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BELL SOUTH TELECOMMUNICATIONS
PER M GRIFFIN 5/15/08 NO
LIC INSURANCE REQUIRED
ATLANTIC BEACH FL 32233
(904) 256-3182
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Permit DRIVEWAY PERMIT
Additional desc .
Permit Fee .00 Plan Check Fee .00
Issue Date 6/11/09 Valuation 0
Expiration Date 12/08/09
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Special Notes and Comments
No work disturbing paved surface of road is authorized.
Complete restoration of right-of-way, including sod, is
required.
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- -------
Permit Fee Total .00 .00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total .00 .00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
.~ra,~J- City of Atlantic Beach
~s ~ `.~;~ Building Department
~ ~ ` ~ 800 Seminole Road
j _ ,, ~ Atlantic Beach, Florida 32233-5445
4 Phone (904) 247-5826 Fax (904)
~a~;~~~ E-mail: building-dept@coab.us
City web-site: http://www.coab.us
l+.iC.;Pii V 1'rL APPLICATION NUMBER
J U N A ~ 20p9 (To be assigned by the Building Department.)
~ 9- ~i9
~ Date routed: ~ eq /U -/
APPLICATION REVIEW AND TRACKING FORM
~b .~~'S~
Property Address:
Applicant: ~ __
Project: ~
De artment review re wired Yes No
ilding
Planning & Zoning
trator
Public Wor
ublic Utilities
Public Safety
Fire Services
Review~fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified B Date
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 Tobaa:o
Other:
APPLICATION STATUS
Reviewing Department First Review: [Approved. ^Denied.
~
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(Circle one.) ~
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Comm nts:. r l ~
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BUILDING F
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/~, ~,k l~~ ~p,,~°"' ~ {~'If'L-`~ ~~~ ~ 1~c.
PLANNING & ZONING ~ kU 7
(~ 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 05114!09
'~S' ~~~,y;: CITY OF ATLANTIC BEACH
r ~~
J~ `~ CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
~,
=r ~ .,
~ 800 Seminole Road 904-247-5800
',` ~ y Atlantic Beach, Florida 32233-5445 Fax 904-247-5845
Date `~C~.~-i ~~ ~ :~~ ~~
PERMIT #
~ s~ _ ~ ~ : ~- ISSUED BY THE CITY
Job Address L~t~'~"~45~ LC,CC~"~iC~i"15~ ,1t.~ ~1~;;~ca,,
Permitee: AT&T (fka BELLSOUTH TELECOMMUNICATIONS) Telephone # 904-7779052 ext 320
Permittee Address: 7666 BLANDING BLVD JACKSONVILLE FL. 32244 ATTN: Nicole Padron
Requesting Permission to Construct: TELEPHONE CABLE AT tT JC.~b ~ ~~.~~ (v ~SCaS ~ It%
Location: (Reference to Cross-Street) `Between Orchid St. and Mayport Rd i~U t ~~~~ `°'~~' Tu ~'
1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities,
both aerial and underground and the accurate locations are shown on the sketches.
A Letter of Notification was mailed to the following Utilities/Municipalities:
Jacksonville Electric Authority Yes (X) No ( ) Date: ~ ~ ~° ' ~~%
Bell South Telephone Company Yes ( ) No ( ) Date:
Ferrell Gas Yes (X) No ( ) Date: 5~ ° ~ ~ ~' J
Comcast i Yes (X) No ( ) Date: 5 - ~~ ~ U9
i
2. I 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 Director of Public
Works, any or all of 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 Director of Public Works, and at the expense of the Permittee unless reimbursement is
authorized.
3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be
performed under the supervision of CLINT STRICKLAND (Contractor's Project Superintendent)
located at Telephone #: 904-393-4958.
4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee.
5. 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.
6. 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
7. This permittee shall commence actual construction in good faith with 60 days. If the beginning date is
more than 60 days from date of permit approval, then permittee must review the permit with the Director of
Public Works to make sure no changes have occurred in the area that would affect the permitted construction.
8. 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.
9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again
immediately upon completion.
OWNER
Signed`r~.(',,L~t.C ~Q.C'~.n..~''r-~ Date: ~ =~L ~-t i
Before me this day of in the County of Duval,
State Of Florida, has personally appeared pJ, comic t~~~Pn.-~n
Notary Public at Large, State of Florida, County of Duval.
My commission expires: ~ b,a. i y ~~N~'°~~
rsona y Known ~ or
Pro u e entification: ~rF"••. BARRY G. WOODS
•'i~
~; ,~ MY COMMISSION # DD 612233
~~%Pf °e0. BondedlThE Notary Public Usdarwrlters