Permit 335 Country Club LN Driveway V j f, .
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1 CITY OF ATLANTIC BEACH
SS
1 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001125 Date 9/14/12
Property Address . . . . . . 335 COUNTRY CLUB LN
Application type description DRIVEWAY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
paver driveway
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Owner Contractor
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WEBB DONNA OWNER
335 COUNTRY CLUB LN
ATLANTIC BEACH FL 322335502
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Permit . . . . . . DRIVEWAY PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 3/13/13
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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 must be set to grade and visible .
Roll off container company must be on City approved list
and container cannot be placed on City right-of-way.
(Approved: Advanced Disposal, Realco, Shappelle ' s and Waste
Management)
Full erosion control measures must be installed and
approved prior to beginning any earth disturbing
activities . Contact Public Works (247-5834) for Erosion
and Sediment Control Inspection prior to start of
construction.
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
UTIL REV MODIF OR ROW 25 . 00
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Fee summary Charged Paid Credited Due
PERMIT IS-APPROVED,ONL-Y--IN A-CCORDANeE-WETfi-Mt-CITY-OF-rt'FLANTIe BEACH-ORDiN' NOES AND-P IE-FLORIDS-
BUILDING CODES.
fr �� CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Page 2
Application Number . . . . . 12-00001125 Date 9/14/12
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.
. .
.'
CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEM
800 Seminole Road 9 47-
4 f=
Atlantic Beach,Florida 32233-5445 Fax
PLEASEGUBCOMPLETE SETS OF PLANS WITH APPLICATION.
'
ISSUED BY THE CITY
Job Address 0"Al I
Permittee Address: 4.2+ 13 7:3
Requesting Permission hoConstruct:
Location: (Reference to C
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 Yeo ( ) No /w/ Date:
Bell South Telephone Company Teo / \ No (v' Date:
Ferrell Gas Yea ( ) No Date:
Comcast Yea ( ) No Date:
2. Whenever necessary for the conatnuotion, napoi[ improvement, maintenance, safe and efficient ooenation,
alteration or relocation of all, or any portion of said street or easement as determined bvthe Director ofPublic
Works, any or all of said po|ea, vvinyn, pipaa, cables or other facilities and appurtenances authorized
hereunder, eho|| be immediately removed from said street oreasement or reset orrelocated hereon as
required by the Director of Public Works, and at the expense of the Permittee unless reimbursement is
authohzed.
3. All work shall meet City of AtlanticTransportation Standards and b
performed under the supervision
dt
.. . - materials and equipment shall -- ---.-__ inspection' by the Director' Public,Works_ or _ designee.
5. All city property shall its naob�nad to � ' ina| condition oofar ao practical, in keeping with ohx specifications
and the manner satisfactory tothe city.
G. A sketch of plans covering details of this inataUadon, as well as, a copy of recent survey shall be made m
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. '-?
date is
7. This ,_��.i'_- shall --�.'m_-- actual construction ' goodfaith- ��_ ---~_-_ ^ . ~
more than 80 days from date of permit appnovn|. 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. |tiounderstood and agreed that the rights and privileges herein set out are granted only tothe extent ofthe
City's right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all
tirnee, moourne all risk of and indernnifv, defend, and aova harmless the City of Atlantic Beach from and
against any and all |oas, donmoga, and 000[ of expenses arising in any manner ofthe exercise or attempted
exercises bythe holder ofthe aforesaid rights and privileges.
9. The Director of Public Works ehoU be notified twenty-four (24) hours prior to starting work and again
immediately upon completion.
OWNER '
�
�
Before .
�
State unFlorida,has personally appeared ��, W,�:X*�) =j
! '~a/' Large,State of Florida,County gf Duval:., —
My commission expires: Personally Known: ~,~
Produced
/
R.O.W. Permit Attachment of for
R.O.W. Permit# issued , 200_ Atlantic Beach, FL 32233
Owner's Name: l. k;aas
Property Address: ,;
cvo
Subdivision: '.-*1L01*MO F,:Z z tt 'j pr '•��
Lot#/Block#: • - �'
R.E. #: 1
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
201x, by Atlantic Beach, Florida, a municipal corporation organized and existing
under the laws of the State of Florida, hereinafter referred to as "CITY" and 1 r.)C i,irj A g P,
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: �: ! u C" i E" : P',I= � -;yi►t i=, 't
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:
.5 LOc:d -IrKy C Lk;)A 1....1v, A-1 1JiJ_)Qt4
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
1 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 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 herei i under the terms of this
permit and that all of said liabilities are hereby assumed by the USER.
DATED and SIGNED this.'.)-7 rH day of f L{>'7 , 20O
Pf erty Owner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
r `t�_. 20(1'. personally appeared before me, a Notary
On this day of tip, i t:
Public in d for said County-, 1 `
County-)and State, *� ' i= . i the property owner of
�'l -"I'-~ Atlantic Beach, Flori a, known to me to be the person(s)
described in and whoaexecuted the foregoing instrument; who acknowledged to me that he or she
executed the same freely and voluntarily and for the uses and purposes therein mentioned.
CHERA E I SARROW
Notary Public in for said County and State' ;
MYCOMMISSIONR E,20150%314
��:� EXPIRES:Maros 8,tot 5
iJ,'Jff Bonded 7hro Notary Public Undewrthen
CITY OF ATLANTIC BEACH,FLORIDA, a
municipal corporation:
Approved:
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
AaftCity of Atlantic Beach APPLICATION NUMBER
'— Building Department - (r'o be assgned by the Building Deperknut)
e00 Seminole Road Z
Atlaniio Beach,Florida 32233-5445
" Phone(904)247-5828 . Fax(904)247-5845
Y4 .lt
E-n 1. bu1k&V4eptQc:oab.us Date routed: Z
Oily web-filer MIAIA ww.ftehme
APPLICATION REVIEW AND TRACKING FORM
Property Address: .� � h G�J� �� ---) JFire
rt,ment review required Yes No
ding
Applicant: �lC� � � � ning&Zoning
Project: / iv,q i91,' , - icic Safety
Services
Other Agency Review or Permit Required Review or Receipt Oats
of Permit Verified ft
Florida Dept.of EnvirorxrrenMat Protection
Fbrida Dept.of Tra mporl *m
St Johns River water Managemerrt District
Anny Caps of Engrrmers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department Fist Review: DApproved. XDenied.
(Circle one.) Con nenfs: <
BUILDING
PLANNING&ZONINGReviewed b ''--r4' cvy
Date.
TREE ADMIN. Second Review: roved as revised.
ODenied.
PUBLIC WORKS Comments:
Puauc uTILrnEs
Reviewed by: Date:
PUBLIC SAFETY
FIRE SERVICES Third Review: []Approved as revised. ODenied.
Comments:
Reviewed by: Date:
Revised OR27M0
City of Atlantic Beach APPUCATION NUMBER
Buliding Department (To be assigned by the Buldkv Dm menta
SW Seminole Road
Atlantic Beech.Florida 32233-5445 l Z - /I
Phone('904)247.5826 - Fax(904)247-5845
E-mak buildfnpl-dept%fCoab.us Dade routed: �c?
City WA4iie! Mlapll Mr eoa�b.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: be rynent ravim Yes No
Building
Applicant C Planning&Zoni
Tree Amin
Project: �� r r� , ' 1�., s� � �
�, r:� ,'... -Public worts-
Public Safety
Fire Parxioes
Outer Agency Review or Permit Required Review or Receipt Daft
of Permit Verified By
Florida Dept.of Envirornentat Protection
Florida Dept.of Trmuporlation
St.Johns River Water Management District
Army C"ps of Engirmers
Division of Hotels and Restaurants
Division of Alooiwlc Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing tlep 4na"t First Review: NWmved. []Denied.
(Cie one) Comments:
BUILDING /� d
PLANNING&ZONING Reviewed by: Date:
TREE ADMIN. Second Review: []Approved as revised. []Denied.
S+P S Comments:
UTILITIES
PUBLIC Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. []Denied.
Comments:
Reviewed by: Date:
tea tn=p