R/W Permit 1100 Sandpiper Ln 2011 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002601 Date 9/13/11
Property Address 1100 SANDPIPER LN
Application type description RIGHT -OF -WAY PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
LAY DOWN YARD
Owner Contractor
CITY OF ATLANTIC BEACH OWNER
800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
Permit RIGHT OF WAY PERMIT
Additional desc .
Permit Fee . . . .00 Plan Check Fee . . .00
Issue Date . . . 9/13/11 Valuation . . . . 0
Expiration Date . 3/12/12
Special Notes and Comments
Full right -of -way restoration, 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.
Sep. 8. 2011 4:16PM No, 2788 P. 3
_:• - CITY OF ATLANTIC BEACH
si,. r, CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
-
800 Seminole Road
-n isi Atlantic Beach, Florida 322 33 - 5445 904- 247 580D �� --
PLEASE SUBMIT (3) COMPLETE SETS OF PLANS WITH APPLICATION. Fax 904 247 - 5845
Date c -_ i
Job Address 1iei �54� PERMIT# `�
''P� ISSUED BY THE CITY 11+
Permittee Address: i •
Requesting Permission to Construct: L a4 ci o a x q ad
Location: (Reference to Cross - Street) , . )pcy1
1. Applicant declares that prior to filing this application he has ascertained the location of all existin utilities
both aerial and underground and the accurate locations are shown on the sketches. g '
A Letter of Notification was mailed to the following Utilities /Municipalities:
Jacksonville Electric Authority
Bell South Telephone Company � Yes ( ) No ( ) Date:
Ferrell Gas Yes ( ) No ( ) Date:
Comcast Yes ( ) No ( ) Date:
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 Be. h or Florida Department of Transportation Standards and be
performed under the supervision of Coe, • - -
Superintendent) located at S. :- (Contractor's Pro'ect
4. Ail materials and equipment shall be subject to Inspection by the Director of Public Works r hhisde g nn ee . � �
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 es, a copy of a recent survey shall be made a
part of this permit. Calculations showin an Increase in Impervious area on owner's lot or in the city
Right of Way are to be Included with this application.
7. T his permittee shall commence actual construction in good faith with 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 /i (�
Signed:
Date: - 9 6/3 > L61
/
Before me this �j v J,�
State Of Florida, has personal a aared f - in the C of Duval.
''`
Notary Public at Large, State of Florida, County of Duv al,
My commission expires:
PeT$Onally Known:
Produced Identlfiratlon:
t-a, v City of Atlantic Beach Q�
' ~ �'
. 4) " .1 APPLICATION NUMBER
A Building Department
800 Seminole Road 1 ` (To be assigned by the Building Department.)
u , Atlantic Beach, Florida 32233 -5445 V" /� -' j tQ d
Phone (904) 247 -5826 • Fax (904) • :45 41 4 7 0#
fit. R !» E -mail: building- dept @coab.us Date routed: 9 9 /1
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND "• ACKING FORM
Property Address: //61 Department review required Yes No
Building
Applicant: ,7 ,L/`t ''')rie (c Planning & Zoning
/_11 Tree Administrator
Project: , d� )611.x`7") A'Z AP Public Works
Public Safety
Fire Services
* � _ .
," � ITS; ," 1- . r ' o '',
," add y P^Y, " -' # ' k4 q s y dr
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: [Approved. ❑Denied.
(Circle one.) Comments: '
BUILDING - ve " 1^
PLANNING & ZONING l
Reviewed by: Date: 9 )L/ i/
TREE ADMIN. Second Review: A roved as revised.
❑ Pp EDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. DDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09