Permit Driveway 1258 Beach 2012 t1 1jr1
0 k 4
,„ s CITY OF
� ,., ATLANTIC BEACH
Ll 7: s) 800 SEMINOLE ROAD
: ..� y .° ATLANTIC BEACH, FL 32233
b.~ Y INSPECTION PHONE LINE 247 -5814
„f it
Application Number 11- 00003018 Date 4/30/12
Property Address 1258 BEACH AVE
Application type description DRIVEWAY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
concrete to pavers
Owner Contractor
DUSH OWNER
1258 BEACH AVENUE
ATLANTIC BEACH FL 32233
Permit DRIVEWAY PERMIT
Additional desc .
Permit Fee . . . 35.00 Plan Check Fee .00
Issue Date Valuation 0
Expiration Date . . 10/27/12
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 an RT1 concrete box with
metal lid. Cleanout to be set to grade and visible.
City sidewalk must be plain concrete.
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.
/ h, ,oc-r. gc, e_ - Po s4•
rs' -4, r' CITY OF ATLANTIC BEACH
Jam,, .}
:y ' CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
8 00 Seminole Road 904 - 247 -5800
1r.) Atlantic Beach, Florida 32233 -5445 Fax 904 - 247 -5845
PLEASE SUBMI (3) CO PLETE SETS OF PLANS WITH APPLICATION.
Date /G. / /
R PERMIT #
Job Address /i S' ,EJ 4 �j / / ✓{. ISSUED BY THE CITY
Permitee: ' c it I 7Ctpr,Ses G-, Telephone # 90 7 ‘‘ 9 '•�q/
Permittee Address: / c J
,2 // ..4 q //VC Z.
Requesting Permission to Construct: /''L/> /otG t UCS f f 7•n5 flit C✓• y [4./i j g�Gl1/e1S
Location: (Reference to Cross - Street) a st sec ..4 //VC
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 (k) Date:
Bell South Telephone Company Yes ( ) No k) Date:
Ferrell Gas Yes ( ) No oe) 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 o,r � D�,ggppaaryment of Transportation Standards and be
performed under the supervision of . 1rf KCc.K tfttrii4, Z, c , (Contractor's Project
Superintendent) located at 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 mariner 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 u.on completi .
OWNER>K ,I,./ � \& JOBSITE COPY
Signed: ` D)e
Before me this A Y day of (' in the Count o", SHIRLEY L GRAHAM
State Of • tori -, ha personally - red j :.4 MY COMMISSION # DD 95776D
Not- ' 4- ubli. at Larg _ , at- of lori• a, / my of Duval. ,•.�� ,, EXPIRES: February 14, 2014
My c•mm \n e •.' / ;f p(g�� underwriters
■ L � -- J Produced Ft31iH ffl - uu
R.O.W. Permit Attachment of for
R.O.W. Permit # issued , 200_ Atlantic Beach, FL 32233
Owner's Name: /o Pr DuS
Property Address: /R51. nvC .
Subdivision:
Lot # / Block #:
R.E. #:
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
, 200_, by Atlantic Beach, Florida, a municipal corporation organized and existing
under the laws of the State of Florida, hereinafter referred to as "CITY" and
of Atlantic Beach, Florida, hereinafter referred to as "USER ".
WITNESSETH:
That the CITY does hereby grant the USER permission on a revocable basis as described herein the
right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of
Atlantic Beach Right -of- Way/Easement permit numbers noted above (copies attached).
This work is generally described as: l ig � 1� S
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted
remains subject to relocation or removal on thirty (30) days notice by CITY to the USER, said notice to
USER shall be given by certified mail, return receipt requested, to the following address:
The depositing of said notice of cancellation in the United States mail shall constitute the notice of
cancellation and the burden is upon USER to keep the CITY informed of USER's proper address.
The USER shall promptly make any and all necessary repairs to any facility erected or maintained in
the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe
condition.
In the event it is necessary for the CITY or the City's approved representative or other franchised
utility to enter upon the above - described property of the CITY, the USER shall replace at the USER's
sole expense, any and all material necessarily displaced during the action of maintaining, repairing,
operating, replacing, or adding to of the utilities and facilities of the CITY or franchise utility provider.
The facilities allowed by the permit shall meet the current requirements of the City Code, Building
Codes, Land Development Code, and all other land use and code requirements of the CITY, including
City Code Section 19 -7 (h) which states "Driveways that cross sidewalks: City sidewalks may not be
replaced with other materials, but must be replaced with smooth concrete left natural in color so that it
matches the existing and adjoining sidewalks."
Page 1 of 2
The USER, prior to making any changes from the approved plans and/or method, must obtain
written approval from the City of Atlantic Beach, Public Works Department, for said change. The
USER shall, at the discretion of the CITY, be requested to submit as -built drawings showing the change
within thirty (30) days after the day of completion.
This pen shall inure to the benefit of, and be binding upon, the USER and their respective
successors and assigns.
USER shall meet the teens and conditions of this permit and to all of the applicable State and CITY
laws and/or specifications, to include utilities locate requirements and use limitations /requirements of
public rights -of -way and other public land. USER further agrees that the CITY and its officers and
employees shall be saved harmless by the USER from any of the work herein under the terms of this
permit and that all of said liabilities are hereby assumed by the USER.
DATED and SIGNED this __ __ da of g e , 2007.
B ' (g:' )
Prope t■ Owner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this /' day of , 200 /personally appeared before me, a Notary
Public in and for said County and State, , the property owner of
, Atlantic Beach, Florida, known to me to be the person(s)
descr . in and who executed the foregoing instrument; who acknowledged to me that he or she
exe ut =: •e m- = - • :ns oluntarily and for the uses and purposes therein mentioned.
Notary 'ublic in for a' County and State
CITY OF ATLANTIC BEACH, FLO
municipal corporation: ;41: °iy SHIRLEY L GRAHAM
*; _._, ; *: MY COMMISSION # DD 957760
EXPIRES: February 14, 2014
Approved' , -04t . / 11 Bonded Thru Notary Public Underwriters
j` (� 1
Ricky L. Ca %er, Public ork Director
For Permits where city sidewalk is impacted,
City Manager approval required:
Han on City Manager
Jim H y
Page 2 of 2
/ibm, , Ot,' Kaye - Du S'.
r _■r CITY OF ATLANTIC BEACH
' � CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
® ti 7 M1w ; _
800 Seminole Road 904-247-5800
61 fi g? Atlantic Beach, Florida 32233 -5445 Fax 904 - 247 -5845
PLEASE SUB (3) CO IPLETE SETS OF PLANS WITH APPLICATION.
Date / �6
6 . PERMIT #
n
p j) /y ISSUED BY THE CITY
.
Job Address /� S ' p �. Q , ` / // ` 6 //' 9
7'CfprrSe5 . c.. Telephone # 9 0 7 -- ".' 5 f'"rq /
Permitee: A � /� C — P
Permittee Address: ‘ ,2// Aria/ c � q A/C_ l' 2-. 1,
Requesting Permission to Construct: ('C /P /4t C C,( S . f T di VC C✓4 4/i I ifie104 Pitle
Location: (Reference to Cross - Street) ass 5ec,.A 4v.
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 (k) Date:
Bell South Telephone Company Yes ( ) No k) Date:
Ferrell Gas Yes ( ) No (k1 Date:
Comcast Yes ( ) No S,0 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 Ioyi D p� ent of Transportation Standards and be
0
performed under the supervision of / C Crr rei.Cslric 4 (Contractor's Project
Superintendent) located at 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 completio . P11 OWNER ul��) E COp ¥
Signed: C, [LW:
Before me this _ / f day of / ,!/ ( in the Count okli SHIRLEY L GRAHAM
State Of Fton� has personally appeared , ' +e
at% `, - MY COMMISS O� i # DO 957760
Notary
publid at Large, tat of lorida, G. my of Duval. ..', r EXPIRES: February 1 4, 2014
My c minis n e;,pire ' �oF s pY{j �(..� Undervvntery
.'(2 �•• IF a -- Produced.
i .
R.O.W. Permit Attachment of for
R.O.W. Permit # issued , 200_ Atlantic Beach, FL 32233
Owner's Name: / p er pus
Property Address: IR 5
Subdivision:
Lot # / Block #:
R.E. #:
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
, 200_, by Atlantic Beach, Florida, a municipal corporation organized and existing
under the laws of the State of Florida, hereinafter referred to as "CITY" and
of Atlantic Beach, Florida, hereinafter referred to as "USER ".
WITNESSETH:
That the CITY does hereby grant the USER permission on a revocable basis as described herein the
right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of
Atlantic Beach Right -of- Way/Easement permit nw.nbers noted above (copies attached).
This work is generally described as: tt) A- y ' 'r ' S
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted
remains subject to relocation or removal on thirty (30) days notice by CITY to the USER, said notice to
USER shall be given by certified mail, return receipt requested, to the following address:
The depositing of said notice of cancellation in the United States mail shall constitute the notice of
cancellation and the burden is upon USER to keep the CITY informed of USER's proper address.
The USER shall promptly make any and all necessary repairs to any facility erected or maintained in
the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe
condition.
In the event it is necessary for the CITY or the City's approved representative or other franchised
utility to enter upon the above - described property of the CITY, the USER shall replace at the USER's
sole expense, any and all material necessarily displaced during the action of maintaining, repairing,
operating, replacing, or adding to of the utilities and facilities of the CITY or franchise utility provider.
The facilities allowed by the permit shall meet the current requirements of the City Code, Building
Codes, Land Development Code, and all other land use and code requirements of the CITY, including
City Code Section 19 -7 (h) which states "Driveways that cross sidewalks: City sidewalks may not be
replaced with other materials, but must be replaced with smooth concrete left natural in color so that it
matches the existing and adjoining sidewalks."
Page 1 of 2
The USER, prior to making any changes from the approved plans and/or method, must obtain
written approval from the City of Atlantic Beach, Public Works Department, for said change. The
USER shall, at the discretion of the CITY, be requested to submit as -built drawings showing the change
within thirty (30) days after the day of completion.
This permit shall inure to the benefit of, and be binding upon, the USER and their respective
successors and assigns.
USER shall meet the terms and conditions of this pennit and to all of the applicable State and CITY
laws and/or specifications, to include utilities locate requirements and use limitations /requirements of
public rights -of -way and other public land. USER further agrees that the CITY and its officers and
employees shall be saved harmless by the USER from any of the work herein under the terms of this
permit and that all of said liabilities are hereby assumed by the USER.
DATED and SIGNED this / 9 day of ,L/ t'- , 200 /.
BY: k tk
.,
Propeti Owner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this 7 day of 7-4 e , 200' personally appeared before me, a Notary
Public in and for said County and State, , the property owner of
, Atlantic Beach, Florida, known to me to be the person(s)
described in and who executed the foregoing instrument; who acknowledged to me that he or she
executed the ame : and oluntarily and for the uses and purposes therein mentioned.
4
Notary • ublic in for . a • County and State
CITY OF ATLANTIC BEACH, FLO it 4, ,
municipal corporation: :vo ; ;; SHIRLEY L GRAHAM
is : = MY COMMISSION R DD 957760
.. d' EXPIRES: February 14, 2014
Approved: r . ` Bonded Thru Notary Public Underwriters
Ricky L. Carper, Public Works Director
For Permits where city sidewalk is impacted,
City Manager approval required:
Jim Hanson, City Manager
Page 2 of 2
r yvi City of Atlantic Beach y APPLICATION NUMBER
4 ' '' Building Department �
'� (To be assigned by the Building Department.)
I 800 Seminole Road 2h 11 / 8
` ,, Atlantic Beach, Florida 32233 -5445 /9 k.)
'r
Phone (904) 247 -5826 • Fax (904) 247 -5845 47„ 7
Date routed:
0 „ ,, ,- v E -mail: building- dept @coab.us
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �2 0 ,� Q C Department review required Yes No
Building
�-
Applicant: / i 1 P e hie - Pi A Planning & Zoning
Tr-.e Ari iR i strator
Project: t f k I k J ,. • • • .
l • ..rc Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
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: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING /> PLANNING & ZONING Reviewed by: Date: V)/ �/
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 05/14/09
\,-if ?, City of Atlantic Beach APPLICATION NUMBER
\ Building Department (To be assigned by the Building Department.)
y + ' s, 2 800 Seminole Road
�d
�' Atlantic Beach, Florida 32233 -5445 CI�E l Z
Phone (904) 24,7 -5826 • Fax (904) 247 -5 C D f
1 4 0 ` — � E -mail: b dept @coab.us A + 20/1 Date routed: /2 / ///
City web -site: http: / /www.coab.us
APPLICATION REVIEW ANIIT ACKING FORM
Property Address: /2 (8 ii 4,6 It A'? Department review required Yes No
Building
Applicant: / C i)1 L' f A Planning & Zoning
/%v',t T mstrator
Project: ,. ,,v, t�7� • ubiic works)
I ublic Utilities)
Public Safety
Fire Services
Review fee $ 26 Dept Signature
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
PLANNING &ZON Reviewed by:_ Date: /,Y(„14 1 »»
TREE ADMIN. Second Review: DApproved as revised. ❑Denied.
P =1" ORKS Comments:
•
PI: UTILITIES
1Z — z1 — t[
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09