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Permit Driveway R/W 1993 Colina Ct 2012 CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ?) =� ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00001609 Date 11/26/12 Property Address . . . . . . 1993 COLINA CT Application type description DRIVEWAY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc New driveway and sidewalk and right of way ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ KING, JOHN TAYLOR CONCRETE SERVICES 1993 COLINA COURT 615 15TH STREET NORTH ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 329-0663 ---------------------------------------------------------------------------- Permit . . . . . . RIGHT OF WAY PERMIT Additional desc . . RIGHT OF WAY Permit Fee . . . . . 00 Plan Check Fee . 00 Issue Date . . . . 11/26/12 Valuation . . . . 0 Expiration Date . . 5/26/13 ---------------------------------------------------------------------------- Special Notes and Comments 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 . 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 area 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. (Approved: Advanced Disposal, Realco, Shappelle ' s and Waste Management . ) Street to be swept daily during construction. ---------------------------------------------------------------------------- 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. CITY OF ATLANTIC BEACH 1 j 800 SEMINOLE ROAD ;) ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 "sem J j31>'" Application Number . . . . . 12-00001609 Date 11/26/12 Property Address . . . . . . 1993 COLINA CT Application type description DRIVEWAY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc New driveway and sidewalk and right of way ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ KING, JOHN TAYLOR CONCRETE SERVICES 1993 COLINA COURT 615 15TH STREET NORTH ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 329-0663 ---------------------------------------------------------------------------- Permit . . . . . . RIGHT OF WAY PERMIT Additional desc . . RIGHT OF WAY Permit Fee . . . . . 00 Plan Check Fee . 00 Issue Date . . . . 11/26/12 Valuation . . . . 0 Expiration Date . . 5/26/13 ---------------------------------------------------------------------------- Special Notes and Comments 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. 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 area 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. (Approved: Advanced Disposal, Realco, Shappelle ' s and Waste Management . ) Street to be swept daily during construction. ---------------------------------------------------------------------------- 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 . 00 . 00 . 00 . 00 PERMIT ISPimmoN(K}1emk1, fO)LocbRDANCE WITH AIQDCITY OF ATLANTk(13EACH ORDINANCQSOAND THE FLORIDAO BUILDING CODES. if L11r CN CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD J = ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Page 2 Application Number . . . . . 12-00001609 Date 11/26/12 Other Fee Total 54 . 00 54 . 00 . 00 . 00 Grand Total 54 . 00 54 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. t� Lyre, City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: /� �� '1,22A, �� Department review required Yes No Building Applicant: L41-0'e' rF Planning &Zoning Tree A ministrator Project: lvglt.) � i�r C��/} ublic Works is iCirtFes /SAIL?Gt �� e y Fire Services Review fee $---� '� 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: J&pproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. P S Comments: U IC UT PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 07/27/10 r CITY OF ATLANTIC BEACH CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS 80D Seminole Road 904-247-5800 Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION. Date _�,;;--(' __--.1'�i�- 2" PERMIT# Job Address I 0 ISSUED BY THE CITY Permitee: `��� Telephone# Permittee Address: -►-1_�j �� �� -k .j ( ,moi. � Requesting Permission to Construct: L'+C-14 is tikes t-t-e r L'y �oe'-.)s_N Location: (Reference to Cross-Street) C1 ceZ\ t "11-1 0-7c 3- 1. -1. Applicant declares that prior to filing this application he has ascertainedthe 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 (/Y No ( ) Date: Ferrell Gas Yes (1./ 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 (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 completion. OWNER Signed: /� '�`%� / Date: /6--30- I �- y1N Notary Public state of Florida Before me this d `y of� C� EcOt, n the County of Duval, aQ Kimberly A Billingsley State Of Florida, has personally appeared My Commission EE 194120 Notary Public at Large,State of Florida,County of Duval. - � Expires 04/30/2016 My commission expires: Perso Produced Identification: BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904)247-5826 Fax (904) 247-5845 Job Address: l[�C�-7� 0 7c Permit Number: Legal Description Parcel# Floor Area o q. t. Sq* t Valuation of Work S Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): Newt, Addition Alteration Repair Move Demolition pool/spa window/door �t Use of existing/proposed structure(s) (circle one): Commercial esidgr 'al If an existing structure,is a fire sprinkler system installed? (Circle one): es No N/A Florida Product Approval# For multiple products use product app—roval form Describe in detail the type of work to be performed:! NL'J,!:, LoeLu a rY-\ �7vr �� � JC► f' l 1 2L ,j` Property Owner Information: Name: + Address: -JA City C 1 e-1aC1, State T ip_-IG> Phone E-Mail or Fax# (Optional) Contractor Information: J_ l� Company Name: lA uoc 4 r-,�i c'tip k, Cu►U-S Quali ing Agent. Address: _`r �� �, City �_N J(*Vc _���e'Je State Zip •? Office Phone eM—meq d Job Site/Contact Number Q(�t 1 - a� (y 2 Fax# State Certification/Registration# Architect Name &Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Application Is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of sixp6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 1 here b cert�'fy that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether speci zed herein or not. The granting of a pernnit does not presume to gave authority to violate or cancel the provisaons o any other federal,state, or local law regulating ruction or the performance of construction. Signature of Owner t� Signature of Con actor PrintNam .( r' ........` .. . ........ ................................................. Print Name ?Y ........... .Y �'. ........................................ Swor td subscribed before me Sworn to and subscribed before me tills-W-1)a of (7o;kcpy->- c 120 l�3( this �I Day of c e r . 20 la Nota No ary ub rN 7c--miss, te of Florida ingsley F^p Vrr Notary Public State of FloridaRe Sed 01.26).10 EE 794120 Kimberly A Billingsleyd 16 p� My Commission EE 194120 R.O.W. Permit Attachment of for R.O.W. Permit# issued , 200_ Atlantic Beach, FL 32233 Owner's Name: Property Address: 4, VLL Subdivision: Lot#/Block#: -2T 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 pennission 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:/� Lw1u o:_ C` 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, opetating,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 mat hes the existing and adjoining sidewalks." Page 1 of 2 i 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(3 0) days after the day of completion. This pen-nit 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 herein under the terms of this permit and that all of said liabilities are hereby assumed by the USER. 411 DATED and SIGNED this day of QQk-bE- ,20$j. Byt ��erty Owner (to be signed in presence of the Notary) STATE OF FLORIDA COUNTY OF DUVAL On this , 2)04" day of 0ckap2C 20$,�, 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 same freely and voluntarily and for the uses and purposes therein mentioned. �4ON Notary Public State of Florida Kimberly A Billingsley My Commission EE 194120 Notary Public in for said County and State arc' Expires 04/3012016 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: Jii Hanson, City Manager Page 2 of 2 OZ City of Atlantic Beach 'CEIV w ! {'~ j APPLICATION NUMBER Building Department OCT � � �Q�Z (To be assigned by the Building Department.)ment. ) 800 Seminole Road Atlantic Beach, Florida 32233-5445 E ` 0 Phone(904)247-5826 • Fax(904)24 %4 - � '#� E-mail: building-dept@coab.us - Date routed: Z City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1�'0 :2 6- Department review required Yes No Building Applicant: /01- 6-22erEF� Planning &Zoning ` / Tree ministrator Project: /V Gtr � ✓� 00A ublicworks / — — 'c ii ety Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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 STATU Reviewing Department First Review: ❑Approved. Denied. (Circle one.) Comments: BUILDING 1 1�*c.�•�G PLANNING&ZONING Reviewed by: Date: TREE ADMIN. Second Review: A roved as revised. pp ❑Denied. PUBLIC WORKS Comments: O � �'�, C PUBLIC UTILITIES 11-11-4 PUBLIC SAFETY Do a � � t,,. i,ReviVINclbDate: FIRE SERVICES Third Review: []Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 07/27/10 Comp. By: RLC SS1 _ r Date: 10/31/2012 V Jii 9f Public Works Department City of Atlantic Beach Permit No: 12-1609 Address: 1999 Brista de Mar Required Storage Volume Criteria: Section 24-66 of the City of Atlantic Beach's Zoning, Subdivsion, and Land Development Regulations requires that the difference between the pre-and postdevelopment volume of stormwawter runoff be stored on site. Volume of Runoff is defined as follows: V= CAR/12 Where: V= Volume of Runoff C = Coefficient of Runoff A=Area of lot in square feet R= 25-yr/24-hr rainfall depth (9.3-inches for Atlantic Beach) Predevelopment Runoff Volume: Lot Area(A) = 13,970 ft2 Runoff Coefficient Area Lot Area Description (ft) (ft) "C" Wtd "C" Impervious 5,654 13,970 1.00 0.40 Pervious 8,316 13,970 0.20 0.12 Runoff Coefficient(C) = 0.52 Runoff Volume V= 0.52 x 13,970 x 9.3 / 12 V= 5,671 ft3 Postdevelopment Runoff Volume: Lot Area (A) = 13,970 ftZ Runoff Coefficient Area Lot Area Description (ft) (ft) "C" Wtd "C" Impervious 6,321 13,970 1.00 0.45 Pervious 7,649 13,970 0.20 0.11 Runoff Coefficient(C) = 0.56 Runoff Volume V= 0.56 x 13,970 x 9.3 / 12 V= 6,084 ft3 Required Storage Volume DV= Postdevelopment Runoff Volume- Predevelopment Runoff Volume DV= 6,084 - 5,671 DV= 414 ft3 Retention 1999 Brista de Mar-onsite Retention w-grnd.xlsx 1013112012 Comp. By: RLC Date. 10/31/2012 Public Works Department City of Atlantic Beach Permit No: 12-1609 Address: 1999 Brista de Mar Provided Storage: Elevation Area Storage (ft) (ft) (ft) 10.0 0 0 BOTTOM 10.3 0 0 TOB Elevation Area Storage (ft) (ft) (ft) 0.0 0 0 BOTTOM 0.5 0 0 TOB Elevation Area Storage (ft) (ft) (ft) 0.0 0 0 BOTTOM 0.5 0 0 TOB Inground storage=A*d*pf A=Area= 0.0 d= depth to ESHWT= 3.0 pf= pore factor= 0.3 Inground Storage= 0.0 ft3 Required Treatment Volume= 414 ft3 Supplied Treatment Volume= 0 ft3 Retention 1999 Brista de Mar-onsite Retention w-grnd.xlsx 10/31/2012 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904)247-5826 Fax (904) 247-5845 Job Address: `��C1 0 A l J/A tri _-T Permit Number: Legal Description Parcel# Floor Area of sq. t. q. t Valuation of Work S Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New; Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s) (circle one): Commercial ;sie al If an existing structure,is a fire sprinkler system installed? (Circle one): s No N/A Florida Product Approval # For multiple products use product approval form Describe in detail the type of work to be performed: l o-e u.- 1 Property Owner Information: Name: -A- Address: -2) City A+k C 1 Cti, State F ip?, 33 Phone E-Mail or Fax# (Optional) Contractor Information: C Company Name: IA4 Lne— C C:)-,:)C:)-,:) I rP res c:.C_S Quali ing Agent: Address 'tz2.P b A rJ City RFU State 1. Zip Office Phone qUI �q ( d a3 Job Site/Contact Number QO (�g3 Fax# State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address a Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for aperiod ofsix�6)months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 1 hereb certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type oj�work will be complied with whether speci aed herein or not. The granting of a permit does not presume to gave authority to violate or cancel the provisions ofany other federal,state, or local law regulating ruction or the performance of construction. Signature of Owners Signature of Con actor _ Print Name .J l��a�.......... .. .J....... ................................................. Print Name 1c) ..........,.1! `��..... t.Q . �....................... . Swo. tQ and subscribed before me Sworn to and subscribed before me this�Da of Do Acbex 201 a this Day 20 la Nota No ary ub tp ,N Notary Public State of Florida Kimberly A Billingsley EQ X-a Notary Public state a FloridaRe sed 01.26.10 My Commission EE 194120 16 Kimberly A Billingsley aA Expires 04/30/2016 d' My Commissan EE 194120 i i t.� w.w EYnima 0A1. n1R rslf'' CITY OF ATLANTIC BEACH n� CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS � Vr 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 Ctl f e � 2 � , ao k FISPERMIT# � SUED BY THE CITY Job Address' t✓ \ A �. (A Permitee: A���� .� �� ���� � 1��I �.� Telephone# Permittee Address: ' 3 ��� Requesting Permission to Construct: 7-Lr"'r c"ovr`Ae4 V% t oe Uv n. +� �•� Ck��l f� 3k-- 06­1'is c t5 r-k, ► Ln A 3 t-el - `tlr Location: Reference to Cross-Street) �� S tiJfa C l + 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 (d/ 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 (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. B. 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 Signed: Date: Notary Public State of Florida Before me is d of ♦olLYrin the County of Duval, -4 . Kimberly A Billingsley State Of Florida,has personally ap ared My Commission EE 194120 or Notary Public at Large,State of Florida,County of Duval. \ Expires 04/30/2016 My commission expires: Cal 3o 1,9pli, Perso Produced Identification: R.O.W. Permit Attachment of for R.O.W. Permit# issued , 200_ Atlantic Beach, FL 32233 Owners Name: ��1�N 4� Property Address: a Rpt Subdivision: Lot#/Block R.E. #: REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of 200_, by Atlantic Beach, Florida, a municipal corpo tion organized and existing under the laws of the State of Florida, hereinafter referred to as "CITY",4nd of Atlantic Beach, Florida, hereinafter referred to as"USER". WITNESSETH: / That the CITY does hereby grant the USER permission o a revocable basis as described herein the right to enter upon the property of th City of Atlantic Bea h for the purpose as described in the City of Atlantic Beach Right-of-)A nt ermit n above (copies attached). This work is generally desc ibed )► 4- .,A. , ' Any facility maintained, repaired, ere ed, and/or installed in the exercise of the privilege granted remains subject to relocation or remova n thirty (30) days notice by CITY to the USER, said notice to USER shall be given by certifie snail, return receipt requested, to the following address: The depositing of said notice f cancellation in the United States mail shall constitute the notice of cancellation and the burden is on USER to keep the CITY infonmed of USER's proper address. The USER shall prompt make any and all necessary repairs to any facility erected or maintained in the exercise of the privile e herein granted and shall at all times maintain said facility in good and safe condition. In the event it i necessary for the CITY or the City's approved representative or other franchised utility to enter up the above-described property of the CITY, the USER shall replace at the USER's soleexpense, and all material necessarily displaced during the action of maintaining, repairing, ope ting,rept Ging, or adding to of the utilities and facilities of the CITY or franchise utility provider. he fa ities allowed by the pen-nit shall meet the current requirements of the City Code, Building Codes, nd 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-nit 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 pen-nit 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 day of CGAOb2�- ,: Ad- Bcs..z Y arty Owner (to be signed in presence of the Notary) STATE OF FLORIDA COUNTY OF DUVAL On this 21041 day of OckobE?c 20Q, 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 same freely and voluntarily and for the uses and purposes therein mentioned. �tr�=E6 r te of Florida [�044'Tdf ngsley E 194120 Notary Public in for said County and State 16 CITY OF ATLANTIC BEACH, FLORIDA, a municipal corporation: Approved: Ricky L. Carper, Public Works Director FoF Permits where city sidewalk is impacted, Cily Manager approval required: Jini Hanson, City Manager Page 2 of 2 �q Y,,S,6, e- 67 C:�.4j i 0--i LdT W��v Nor ' . ).. low 'S�, ' �► Iri/1640 "!i' /c/ti A Av;-NaivY Sc/sA�l/ -�►I."a! �C�rvE J Bf�i:C fin_STn cI T;c4n4Z' Tire-E �vrv.Q.4►,vcF_ c`e.v�,�sov�' F_/_E✓ATi�rc,�� S,e,/dX�"C,,` T'Ui�`S- ' �O.G 7) /�.u0 .4.'.���.[' Td n.!G,F: I.�?O:'C/.vl IWE/F'F Alr ✓/S�R�E Er4SF_�-'E,+iT ExCE T .4S ,5'N�ivN cAl S.41,51 Gni I /ref •` � I d a � i PK or Q, 3r o F/PA�fE(/0 79) +. Mt tn el I, �� X61•-rr Q� a'D ` a WO Y 6 ID 00 � 5 C� c � �a� L 1 ^,9 'a 'i i h t V i Dr r. r T'I . BAS BAS;FUAIE ' FGRLu —'� ?,a 1993 COLINA CT Atlantic Beach FL 32233 Building Type 0102 - SFR 2 STORY SOH Year Built 1985 Building Value $119,651.00 Type Gross Area Heated Area Effective Area Base Area 745 745 745 Addition 864 864 778 Finished Garage 480 0 240 Base Area 705 705 705 Finished upper story 1 705 705 670 Base Area 128 128 128 Finished Open Porch 18 0 5 Finished upper story 1 18 18 17 Base Area 54 54 54 Total 3717 3219 3342 Front 88.00 pepth 158.00