Permit R/W 1460 Beach 2011 it 11 CITY OF ATLAN'IC BEACH
'-.� s) 800 S1MINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002523 Date 9/07/11
Property Address 1460 BEACH AVE
Application type description RIGHT -OF -WAY PERMIT'
Property Zoning RES SF DISTRICT
Application valuation . . . 0
Application desc
CHANGE OUT CURB
Owner Contractor
HELLER OWNER
ATLANTIC BEACH FL 32233
Permit RIGHT OF WAY PERMIT
Additional desc .
Permit Fee . . . 35.00 Plan Check 'ee . . .00
Issue Date . . . Valuation . . . 0
Expiration Date . 3/05/12
Special Notes and Comments
Avoid damage to underground water /sewer utilities. Verify
vertical and horizontal location of utilities. Hand dig if
necessary. If field coordination is needed, call 247 -5834.
Other Fees STATE DCA SURCHARGE 2.00
ENG REV BLDG MOD OR ROW 25.00
STATE DBPR SURCHARGE 2.00
UTIL REV MODIF OR ROW 25.00
Fee summary Charged Paid Credited Due
Permit Fee Total 35.00 35.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 54.00 54.00 .00 .00
Grand Total 89.00 89.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
`' CITY OF ATLANTIC BEACH
I :'t
800 Seminole
CONSTRUCTRoad ION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
4,,. 904- 247 -5800
s,. Atlantic Beach, Florida 32233 -5445 Fax 904 - 247 -5845
Date 4 3 l'? Zo (f ,
., ,�, n
PERMIT*
(oG�
Job Address I I t lA / /4�- f e A — e�.R �L
< 3 ISSUED BY THE CITY
Permiee: 1 Z Telephone # 5 - 77t..9 - X2-23
Permittee Address: 1 (ID F AR AuteNtA,
`
R -qu -sting Permission to Construct: C.hr � t 1'.5i' ► s fa • • .; • • , ..• sti . , _
L. tsu
■ i , A� , /tom °b (�4.e, A RUty ff tt •
Location: ('eference to Cross-Street)
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. 1
A Letter of Notification was mailed to the following Utilities /Municipalities: — &,t),i 1 Sun! Jkitt- . Kocce
Jacksonville Electric Authority Yes ( ) No ( ) Date:
Bell 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,
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 Flori a Department of Transportation Standards and be
performed under the supervision of O>"t v' (Contractor's Project
Superintendent) located at 3S1 11- 54. RI, ?i�3 3 Telephone #: '31-19 803
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. 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. 40 7. This permittee shall commence actual construction in good faith with W 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
Signe 4 — Date: / fig /�
Befor me this \ ` day of in the ounty o Du a
State Of Florida, has personally appeared `, '♦ el {4
Notary Public at Large, State of Florida, County of Duval.
My commission expires _ _ _ . —
Personally Known:
Produced Identification: —�.... 4%:;:f ° 4 ': COLLEEN A . K G
I 1 c ' .. S Notary Public - State of Florida
s • 416 ' o c • My Comm. Expires Dec 7, 2013
� ' • . '4'. elk.' Commission #E DD 944840
4
0 !.tV.P, e4 City of Atlantic Beach "` '
tY APPLICATION NUMBER
���,�`+�.
S �t Building Department (To be assigned by the Building Department.)
r � s � Atlantic Beach, Florida 32233-5445 VA.
pl ' /
�� s 800 Seminole Road '';
'� Phone (904) 247 -5826 • Fax (904) 247-
, n„o ;t !P E -mail: building- dept @coab.us Date routed: i �
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /�& d ge d eh 7 U� Department review required Yes No
Building
Applicant: Tic!) Ili/lee Planning & Zoning
(,:t/ . Tree Administrator
Project: ,�/ �d � �� o
tblic Utilities - )
Public Safety
Fire Services
4 rA it =, ' 1,",'',:,),...4 % c ..
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:
APPLICATION STATUS
Reviewing Department First Review: pproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING
Reviewed by: Date: g /
THE MIN. Second Review: Approved as revised. ['Denied.
. e = Comments:
PUBLI ILITIE
:.?3-I !
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
•i� City of Atlantic Beach , . APPLICATION NUMBER
S
r yL *.
D. Phone (904) 247 -5826 Fax (904) 47. 645 " O
0 Building Department ""^ ' t
i (To be assigned by the Building Department.)
• ; 800 Seminole Road
r Atlantic Beach, Florida 32233 -5445 4 00 ` / `
.,, l; ar Email: building dept @coab.us Date routed:
mor
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TIR A C IN G,FO. �y ■AM ■� �� 1
I1� . \ 1 �� , o 1 I' 6 / J e• g e/) / t• De 1111\
ent r��riew required Property Address: � p q Yes No
Building
Applicant: / ) )i / fe Planning & Zoning
- ree Administrator
Project: .4 , e i7-/) . Z. c- wQrks)
ubli• Utilif es )
e Public aft
O ') �o _, Fire S= rvices
a-- e...„ )
Review fee .... , x y r t bep Sig:40+
Other Agency - eview or Permit Required Review pt Date
of Permit Verified By
Florida Dept. of En • onmental Protection ,-
Florida Dept. of Transp• • ation __,._.- ---"`--'
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:
BUILDING
PLANNING & ZONING Reviewed by: ,10V 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 07/27/10
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