357 4th st JEA POLE 2013 rssa..,y City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by�stilding Dzpar""en"
800 Seminole Road Q
Atlantic Beach. Florida 32233-5445 79
.rd Phone(M)247-5M - Fax(W4)247-5845 // 3
E-mail: building-deptacoab.us Date routed.
Cityweb-site: http:ff*w v.ccab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �7 i t Department review required lies No
Building
Applicant: �� Planning&Zoning
L Tree Administrator
Project: �d J G Public Works
Public Utilities
Public Safety
Fire Services T-A
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 Distract
Army Corps of Engineers
Division of Hotels and Restaurants
Division of AJcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: (]Approved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by: Date:
TREE ADMIN. Second Review: QApproved as revised. E]Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: (]Approved as revised. [Denied.
Comments:
Reviewed by: Date:
Revise+3 07127110
CITY OF ATLANTIC BEACH
r r CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
U 800 Seminole Road 904-247
5800
++ jyr nVV Atlantic Beach,Florida 32213_5445 Fax 904-247-5845
Date t I �ERMIT• ^�
SUED BY THE CITY
Job Address � '�_S � � T —} t
Permitee: G J Telephone#
Permittee Address: `
Requesting Permission to C nstruct: ;�> + 5� <<�t - �r\K'
s L. F
Location: (Reference to Cross-Street)
1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities,
both aerial and underground and the accurate locations are shown on the sketches.
A Letter of Notification was waited to the following UtiGtieslMunicipalities: t)s r � �L t..
S _f.s "a
Jacksonville Electric Authority Yes( ) No ( ) Date:
Bell South Telephone Company Yes( ) No ( ) Date:
Ferrell GasDater
Yes( ) No ( )
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 1 r(A (Contractor's Project
Superintendent)located at ) Sf A ��c �' ��� � + T� s" Telephone#: �C�S`���z�J
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.
S. 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. Caitcutations showing any increzise in impef-Aoits ern r on owner's tot or in the cit'
Right of Way are to be Included with this application. s If the beginning date is
7. This permittee shall commence actual construction in good faith with , days. 9 9
ittee must review the permit with the Director of
more than 60 days from date of permit approval, then perm
Public Works to make sure no changes have occurred in the area that would affect the permitted construction.
a. 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 indemnity, 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.
g. The Director of Public Works shall be notified twenty-four (24) hours prior to staring work and again
immediately upon completion.
OWNER
Signed e
Date: �tn
Beton:m the day of the County of Cuval,
State Of rida.has personally appeared
Notary bllc at Large.State of Florida,County of Duval.
My commission expires:
Personalty Known:
Produced identification: ----
PEGGY CARTER
1 MY COMMISSION f 0 984708
EXPIRES:April 27,2014
..n{ RW9d Thru Notary Pubk U rs
ENGINEERING DESIGN
ORACLE PERMIT MAXIMO DATE REL
PROJECT M 8001511 N.O.: 2013.1946.910 WO#: 21472180 CONST:Oi-10-2013
CIR. TREE TRIMMING
SUB-STA: NEPTUNE N.O.: 563 RE4'D:YES
CELL 904-219-9714
ENGINEER:HGALE N.O.: ZIP CODE: 32233
CUSTOMER/ SVC PHONE
LOCATION: 357 4TH ST.(X-STR SHERRY DR.) CENTER: SOUTH N.O.:665.4191
THIS PROJECT PROPOSES TO INSTALL(1) 35 FT WOOD CLEARANCE POLE AND SECONDARY BUS TO FEED A
NEW RESIDENCE AT 357 4TH STREET,ATLANTIC BEACH.
POLE STAKED AND PVMNT MARKED ON 1-7-2013.
PLEASE USE ONE CALL SYSTEM AND NOTIFY THE CITY OF ATLANTIC BEACH AT 904-247-5834 AT LEAST 24
HOURS PROIR BEGINNING WORK.
• 346 344 34 3 3
$ 354 352 351 345 3 5 3 1
35
371 363 351 N
3891 37 5 ' W E
7 373
• ` ul STA 02 - INSTALL 35 FT. WOOD
POLE #359 & CONNECT TO 2/0
a3 ON FRM STA 01. /
4T
2/0?
OP .
_g
CAUTION BURIED UTILITIES- 5a` co
W
HAND DIG AS NEEDED 4T 1/oT t73
0 4T-P STA 01 - CONNECT TO
N T 4T EX. SECONDARY POLE #356
P
I/op
& RUN 60 FT OF 2/0 PAP
TO STA 02
•. 339
364 • 350 340
364-1 S 346
. •72 ♦ 369 360 354 347
376 374 374 36311 349
�►
379 381 379 369 3 l