Permit JEA 2305 Mayport 2011 ;11.44'4. City of Atlantic Beach
;11.44'4. APPLICATION NUMBER
e. T s1 Building Department I REP 0 2 2010 (To be assigned by the Building Department.)
r i 800 Seminole Road i ; 4 ,, 4145
j , Atlantic Beach, Florida 32233 -5445 F
Phone (904) 247 -5826 • Fax (904)047-5845,
- 3 » E -mail: building- dept @coab.us Date routed: `j' /71)
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 02 ° 5 , A a 0 ie 7 ITU Department review required Yes No
p / P Building
Applicant: � -- y� - -• Planning & Zoning
Tree Administrator
Project: . t - L , £s Public Works
~�
Public Sa of ty
Fire Services
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Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
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:
\43. Approved. APPPLICATION STATUS
Reviewing Department First Review: ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING Reviewed b Date: 9- c /o
TREE ADMIN.
�„�, Second Review: ['Approved as revised. DDenied.
��� :,ii"'"� Comments:
i
PUB �� AFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. ['Denied.
Comments:
Reviewed by: 9 - e:
4
Revised 05/14/09
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CITY OF ATLANTIC B
CONSTRUCTION PERMIT i t tit, CPJu 4, � J i! Y AND EASEMENTS
800 Seminole Road 904441-5500
wi Atlantic Fb II rlda 32233.5445 Fax 904-2414145
i •
• _ SEP J
Date
Job Address 305 in/4) / y O .e / - ; , THE CITY
P•rmitee: Nei? RA /fd 2 y Telephone # q 04 1 1- 733 6 9 7
P.rmlttee Access: // 7 Q. 3 C' //i Rd
Requesting Permission to Construct Z U - i J / i 5 i L,1 b S
Location: (Reference to Cross-Street)
1. Applicant declares that prior to filing this application he has ascertained the location of all exlsting 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 (') No ( ) Date:
Bel South Telephone Company Yes ( No ( ) Date:
Ferrell Gas Yes ( No ( ) Date:
Comcast Yes ( No ( ) Date:
2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation,
ash or relocation of al, or any portion of said street or easement as determined by the Director of Public
Works, any or an of said poles, wires, pipes, cables or other fadlitl s 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 Pernittee Mess reimbursement is
authorized.
3. Al work shall meet City of Atlantic B - . . or -rids Department of Transportation Standards and be
performed under the of & , - ► 4: „___,(Contractor`s
Superintendent) located at 117 . S . r"/ 4 - Telephone #: Q @ // - rl q o 5',y,
4. Al materials and equOmi shall be subject to inspection by the Director of Public Works or his designee.
5. Al 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. • 1 f •u t ' 1 1 1 11 r. • • 1 •► t 1 4' " 1 1 1 i 1
Rlaht of Wav are to be included with this anallcation,
7. This permitted shall commence actual construction in good faith with days. It the beginning date Is
more than 60 days from date of permit approval, then permittee must review the permit with the Director of
Pubic Works to make sure no changes have occurred in the area that would affect the permttted 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 Molder will, at .l
times, assume all risk of and indemnlfy, defend, and save harmless the City of Atlantic Bosch from and
against any and ail 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 prix to starting work and again
immediately upon completion.
OWNER
Signed: Date:
Before me this day of in the County of Duval,
State Of Florida, has personally appeared
Notary Pubac at Large, ate of Florida, County of Duval.
My commission expires:
Personally Known: or
Produced IdentNlatiox
ENGINEERING DESIGN
PERMIT DATE REL
MAXIMO# 20370416 N.O. NIA PROJECT #: 1013310
CONST: 8/2512010
SUB -STA MAYPORT CIR. TREE TRIMMING
N.O.: 594 REQV: NO
CELL
ENGINEER: Robert Simpson N.0.: 497.2271 ZIP CODE: N!A
CUSTOMER/
LOCATION: 2305 MAYPORT RD/ RECONDUCTOR 594 CENT V ER SSSC p.: 665-7793
Lel i :1'l •:: - 300A8C i
STA 1, P# 2305 MAYPORT RD, HANG (3) NEW 80T SWITCHES OH Is
TO FEED UG. REPLACE RISER INTERCEPT CONDUIT AT STA 2.
STA 2, MANHOLE # 2305 MAYPORT RD, INTERCEPT CONDUIT,
INSTALL MANHOLE.
*k*** CONTRACT ADMIN *****
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