330 Country Club Ln 2013 Driveway ,C,� CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
�Jill rrl
Application Number . . . . . 13-00002552 Date 5/16/13
Property Address . . . . . . 330 COUNTRY CLUB LN
Application type description RIGHT-OF-WAY PERMIT
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 0
------------------------------------------------
Application desc
driveway pavers/walkway
-------------------------------------------------
Owner Contractor
-
------------------------
-----------------------
PARKER EARL W JR & LEYA M OWNER
505 BASSWOOD CT
JACKSONVILLE FL 32259
-----------------------------------------------
Permit . . . . . . RIGHT OF WAY PERMIT
Additional desc .
Permit Fee . . . . 35 . 00 Plan Check Fee 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 11/12/13
---------------------------------------------
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 .
If on-site storage is required, a post construction
topographic survey documenting proper construction will be
required.
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.
Approx. 575 SF increase in Impervious Surface yields 355
cubic feet increase in on-site storage requirement .
Provide revised on-site storage plan.
Maximum driveway widgth through right-of-way is 201 .
------------------------------
Other Fees
UTIL REV MODIF OR ROW 25
_
00
--------- -------
Fee summary Charged Paid Credited Due
g ----------
----- ---------- -
Permith� Fee �7T++ottal 35 - 00(�� 35 . 00(�(� . 00 . 00
PERMIT ISP V91@1 _V llC9C&IRDANCE WITH ALP' ITV OF ATLANTIC $EACH ORDINANCEOSOAND THE FLORIDAOO
BUILDING CODES.
CITY OF ATLANTIC BEACH
1 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Page 2
Application Number . . . . . 13-00002552 Date 5/16/13
Other Fee Total 25 . 00 25 . 00 . 00 . 00
Grand Total 60 . 00 60 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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SER RESIDENCE
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3EAC FLORIDA.
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2"FDrTm
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CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
800 Seminole Road 904247-5800
7— Atlantic Beach,Florida 32233-5445 Fax 904-247-5845
PLEASE SUBNIICOMPLETE SETS OF PLANS WITH APPLICATION.
Date g r3�� PERMIT#
Job Address Lo„/\J, ISSUED BY THE CITY
Permitee: Epic- PwS }�O Scgpe Q)n&* Z %C• Telephone# .3- ��,3�
Permittee Address: 3R4B 3"- S'1c- S 'L 32250
1
Requesting Permission to Construct: Jewfk1C,.y Pa*r6/S )
Location: (Reference to Cross-Street) Ccxx rat cN,�
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 (� o ( ) Date:
Ferrell Gas Yes ( o ( ) Date:
Comcast Yes ( o ( ) 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 _ n - ML L-ecc), _ (Contractor's Project
Superintendent) located.at2Q5/S '$cCt-=& -& 11C Telephone* rbtd-2.1;3-'TO 31
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 _30 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. g
OWNERr LAUREN MARY PJICLEOD
/ JL.
��C� ��.��,� •'c MY COMMISSION#DD984996
Signed: EXPIRES April 25,2014
Before me this a N "s^ aay of ri s in the CQ�nty of Duval, "
State Of Florida,has personally appeared 1-P Ll Par/L i°r'_ 0153 FloriaaNcrary=<'w ce wm
Notary Public at Large,State of Florid Coun of uval.
My commission expires: Al��� 4 1 P rsonally Know
Produced Identification:
R.O.W. Permit Attachment of for
R.O.W. Permit# issued , 20 Atlantic Beach, FL 32233
Owner's Name:
Property Address:
Subdivision:
Lot#/Block#:
R.E. #:
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
, 20_, 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:
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 insure 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 rby the USER.
DATED and SIGNED this p day of Y J , 20/3
By: W�' ►"' LAUREN MARY MCLEOD
Prope Owner = •= MY COMMISSION#DD984NO
(to be signed in presence of the Notary) EXPIRES April 25,2014
STATE OF FLORIDA
COUNTY OF DUVAL
On this 2& day of 20'1 personally appeared before me, a Notary
Public in and for said County and State, �_eU a P0Lk-V_e r- , 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.
Q4Y Me, �Md
Notary Public in for said County and State
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
RECETVT-,L?
i City of Atlantic Beach APR 2 6 2013U
F ;' I�i4l'ON�NIMBERt
' R s€
Building Departmentbe� �red�fiytfsu�dmg Depaltment)
OEM 800 Seminole Road ' ��
. _ Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 ` x ' r
E-mail: building-dept@coab.us r
Cite web-site: htfpWwww.coab.us -- —
APPLICATION REVIEW ANV TRACKIN0 PORN!
/
Property Address: / Department review required Yes No
Building -
Applicant: r D sC Planning&zoning
Tre dmini.$trator
Project: I 1 ubli
u 'c Utilities
Public 89eby
F' ervices
Other Agency Review or Pennit 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 v
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other.
APPLICX ION STATUS
Reviewing Department First Review: k.A�p/roved.- ❑Denied.
i (Circle one.) Comments:
BUILDING
I
f PLANNING&ZONING Reviewed Date:
i
TREE ADMIN. Second Review:
❑Approved as revised. ❑Denied.
P Comments:
L TILITIES
PU LIC SAFETY Reviewed by:� Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments: i
Reviewed by: Date:
Revised 07127110
=" City of Atlantic Beachr�'FTVED
Building Department MAY 0 1 2013 '
800 Seminole Road
a :n
Atlantic Beach,Florida 32233-5445 ti
Phone(904)247-5828 • Fax(904)
E-mail: building-dept@coab.us
• City web-site: http•J/www.coab.us �.
APPLICATION REVIEW AND TRACKING FORM
Properly Address: C'C l I �t `�� C�l' � �nE
ent review required Yes No
�n_
;BuApplicant: A Q` r c� � �uti-�S I�i;,�- toninTreor
Project: SC(te,t^CA 20DI ,kW(-V= ub
Pu is 'lilies
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 STATUS
Reviewing Department First Review: Approved. []Denied.
(Cirde one.) Comments:xlw
BUILDING �
PLANNING&ZONING Reviewed by: Date:
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:
Revd 071271`10