Permit Driveway 27 Forrestal Cir 2012 C . tJ/
r" CITY OF ATLANTIC BEACH ii %' 800 SEMINOLE ROAD
J 0. ,.,; ATLANTIC BEACH, FL 32233
.; INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000083 Date 1/31/12
Property Address 27 FORRESTAL CIR
Application type description RIGHT -OF -WAY PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
concrete for concrete driveway
Owner Contractor
DAGLEY, DONALD OWNER
2555 PEACH DRIVE
JACKSONVILLE FL 32246
Permit DRIVEWAY PERMIT
Additional desc .
Permit Fee . . . 35.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 7/29/12
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.
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 and RT1 concrete box with
metal lid. Cleanout to be set to grade and visible.
All concrete aprons must be 5" thick, 4000 psi, with
fibermesh from the edge of pavement to the property line.
Reinforcing rods or mesh are not allowed in the
right -of -way.
Roll off container company must be on City approved list
and container cannot be placed on City right -of -way.
Contact Public Works (247 -5834) for Erosion and Sediment
Control Inspection prior to start of construction.
All concrete driveway aprons must be 5" thick, 4000 psi,
with fibermesh from the edge of pavement to the property
line. Reinforcing rods or mesh are not allowed in the
right -of -way.
Roll off container company must be on City approved list
and container cannot be placed on City right -of -way.
Contact Public Works (247 -5834) for Erosion and Sediment
PERMIT IS ®u.. oinspealobalaiNpriagti XI attia6KAUANI4P AND THE FLORIDA
BUILDING CODES.
* \1� CITY OF ATLANTIC BEACH
A rl 800 SEMINOLE ROAD
0'°-- — — --f ATLANTIC BEACH, FL 32233
4. ,m ► may INSPECTION PHONE LINE 247 -5814
�Ji3
Page 2
Application Number 12- 00000083 Date 1/31/12
Other Fees STATE DCA SURCHARGE 2.00
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 29.00 29.00 .00 .00
Grand Total 64.00 64.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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" CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
!To
800 Seminole Road 904- 247 -5800
Atlantic Beach, Florida 32233 -5445 Fax 904 -247 -5845
PLEASE SUBMIT (3) COMPLETE SETS OF PLANS WITH APPLICATION.
Date l a 3—R0/2— PERMIT #
Job Address 7 Forres 1 61rcl•e, iu 14/iii/4 T3 322 33 ISSUED BY THE CITY
Permitee: 6J- �v4/orc71 -e. SerY1C7c JAJc . Telephone # - S3 , " PJ
Permittee Address: 14-45 Pia l( , i-ar) r dlcf f ti d ur5 , t" - 3.2 D 6 g
Requesting Permission to Construct: (o ,Jere4>✓ +6 (6nl Cr'c4 CA t-iucwcy
Location: (Reference 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.
A Letter of Notification was mailed to the following Utilities /Municipalities:
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 Florida Department of Transportation Standards and be
performed under the supervision of C,si -S 61�€4t gcrv,c= •- (Contractor's Project
Superintendent) located at /44 7AJe I '/1'4( / /1//aditi v5, 7 L 3e06 Sl Telephone #:
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.
7. This 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.
Si. • •. rr , ■41111. Date: / 4. /
,3/ , Z.
efore me this / • - • in the County o
ate 0 • da, hasp a onally .. ppeared I . ?"";Y ., SHIRLEY L. GRAHAM
.: • blic at La • , Stet= of lorida, Cou • . of Duval. MY COMMISSION # DD 957760
Uary 14 2014
. •
Public Underwriters
_ i<• j/ ����w Produced Ide I r +
r City of Atlantic Beach RECEIVED APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road JAN 2 3 2012 / ,• b 3
Atlantic Beach, Florida 32233 -5445 _ /
Phone (904) 247 -5826 • Fax (904) - 5 Z
E -mail: building- dept @coab.us Date routed: 02$
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: c2 ? /"D ( le // Department review required Yes No
Building
Applicant: .,c J 677 erf Ti. Planning & Zoning
Tre- . • • strator
Project: COh Cti f 77 12IIi efrc •ublic W• .
• is Utiliti-
Y4IQ #y Public Safety
Fire Services
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. IKDenied.
(Circle one.) Comments: czJL, :
BUILDING
PLANNING & ZONING Reviewed by: Date: /2,4
Z
y
TREE ADMIN. Second Review: Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES P BLIC SAFETY Reviewed by: ` dift„/
— Date: //Ph/
FIRE SERVICES Third Review: ['Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
City of Atlantic Beach RECEIVED APPLICATION NUMBER
r Building Department (To be assigned by the Building Department.)
800 Seminole Road JAN 2 3 2012
z Atlantic Beach, Florida 32233 -5445 ? D
Phone (904) 247 -5826 • Fax (904) 2145 a3 �Z
v r F3 �? E -mail: building- dept @coab.us Date routed:
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: c72 1 /"D /fiSTR L , e Department review required Yes No
Building
Applicant:
Applicant: . , J 67, d rill_ Planning & Zoning
Tre- , • . •strator
Project: C Oh erin &fieRtif -ublic W. .
.lic Utiliti
id Ay Public Safety
Fire Services
Review or Receipt Date
Other Agency Review or Permit Required 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
ZONING ) ' F h 2
PLANNING & ZO Date:
Reviewed by: < /�
TREE , DMIN. Second Review: Approved as revised. ❑Denied.
p, .Atri k Comments:
IE
PU: IC A ETV— Reviewed by:
Date:
FIRE SERVICES Third Review: Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10 ��A(
4T
41•10.