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
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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