149 Beach Ave driveway 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
it
Application Number . . . . . 13-00002803 Date 6/14/13
Property Address . . . . . . 149 BEACH AVE
Application type description RIGHT-OF-WAY PERMIT
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 0
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Application desc
REPLACE DRIVEWAY
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Owner Contractor
------------------------ ------------------------
SSR FAMILY LTD ET AT OWNER
3300 PHILLIPS HIGHWAY
JACKSONVILLE FL 32207
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Permit . . . . . . DRIVEWAY PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 12/11/13
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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 .
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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
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35 . 00 35 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 54 . 00 54 . 00 . 00 . 00
Grand Total 89 . 00 89 . 00 . 00 . 00
PERMIT IS APPROVED ONLV IN ACCORDANCE WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NTIC BEACH
CITY OF ATLA
CONSTRUCTION PERMIT WITHIN CITY RIGI ITS OF VVAY AND EASEMENTS
-247-5800
904
800 Seminole Road
Fax 904-247-1�845
Atlantic Beach,Florida 32233-5,eA5 �01_ffc I�
PLEASE SUBMkT4*COMPLETE SETS OF PLANS WITH APPLICATION. Y116'
Date-- PERMIT#
ISSUED BY THE CITY_Z
Job Address 141
Permitee: Telephone#
Permittee Address:
Requesting Permission to Construct: kro 4--&,r',5 7-/4/(5t D,1, 01AJJ ��
Location: (Reference to Cross,91breet) Zr,4CA11,11ai',
1. Applicant declares that prior to filing this application he nas ascertained the !ocation of a!I existing utilities,
both aerial and underground and ihe accurate locatiops are Shown �,.)n the sketches.
A Letter of Notification was mailed to the following Utilities/hlluniclparlties:
Jacksonville Electric Authority �0 ) No ( ) Date:
Bell South Telephone Company .( ) 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 oreasenient 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 Permit.tee unless reimbursement is
authorized.
3. All work shall meet City of Atlantic Beach or Flodda Depaft�ent of Transportation Standards and be
a C( '?A _(Contractor.s Project
performed under the supervision of _4'D,4&1i-,c
Superintendent) iocated at L_LZ2_ C ---Telephone
4. All materials and equipment shall be subject to inspection by the Director of Public,Works or his designee.
5. All city property snall 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 detail.'s of tiis install'aticn, -qs �wc-ll as, a copy of a recent survey shall be made a
part of this pennit Calculations sihowirl ny increase 1, hy—mervious area on owner's lot or in ihe city
kight of Way are to be included with this application. with J- days. If the beginning data is
7. This permittee shall commence actual constructiun in good faith
more than 60 days from date, of perinit approval, then pernnittee must review the permit with the Director of
Public Works to make sure no charges have occurred in the area that would affect the permitted construction.
3. It is understood and agreed that the rights and privi!eges herein set out are granted only to the extent of the
City's right, title and interest in the land to be enterad 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. ior to starting work and again
9. The Director of Public Works shall be notified tviventy-four (24) hours pr
immediately upon completion.
OWNER AMY DBROOKS
Notary PUbliC-state of Florida
Signed: El�te: My Comm. Expires Aug 5,2015
Jin the County cf Commission#EE 114753
Before,rne ---.-da)dof 4 tA - P"' Duval,
ttL_ 0,W
State Of Florida,has personally appeared ;"�,;.... Bonded Through National Notary Assn.
Notary Public at Large,StatQ of Flonda,County of Duval. E I
my commission expires: Personally Knovvn:
Produced Identification: I—A"0/3q0U61____
REMDVE SHIPCAI
SONG ANDVVINDCOAS,
INSTAo-I t*-)AI S�qk�a ES
AND SIDNG To
EXIS.tNG GARAGE 2NC ST(qv
20-4 1.17 VoOOD 0 KK
Tw=IST n FTF
6RY JALL-,
GAPLAGE .kTAJRS
Wq
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Lu
Rem:6ve-Existing
Concrete WCRKER PARMG
Driveway and
Replace with New
Concrete
PORTANLE
70IL"
CITY OF ATLAbM C
BEACH JOB$RE WN
1 ,19 Be,
AtIcantic
06/04/13 07 : 43 AM 01/01
CONFRM 00000 CALL SUNSHINE 06/04/13 07 :43: 06ET lSS300347--OCO STREET
Ticket : lSS300347 Rov:000 Taken: 06/04/13 07 :29ET
state; FL Cnty:i DUVAL GeoPlaCe': ATLRNTIC BEACH Fcljf RGC()'VQd
callerPlace: ATLANTIC BEACH JUAI 2013
Subdivision:
Address 149 Keny0j, Co.
Street BEACH AVE
cross 1 2ND ST
Within 1/4 mile: Y
Locat: LOCATE ENTIRE W SIDE OF 7ROPERTY AT 149 BEACH AVE
Remarks LOOKUP BY ADDRESS
Grids 3019BS123A 30195812-3:5
Work date: 06/07/13 Time' 07 : 00EIr Hrs notc: 071 Category- 3 Duration.- 05 DAYS
Due Date : 06/06/13 Time: 23:59ET Hxp Date : 07/05/13 Timo: 23:59ET
Work type: DRIVEWAY WORK Boring: 11 White-lined: Y
Ug/Oh/Both: U Machinery: Y Dey�h', SIN Permits: Y ON $:CTE
Done for ANN RILEY
Company DANA 5 KENYON COMPANY Type: CONT
Co addr 5772 TIMUQUANA RD
city JACKSONVILLE State : F3'j Zip: 32210
Caller DAVID CLARK Phone: 904-777-0833
Contact DAVID CLARK Phone: 904-626-5664
BestTime: ANYT
Mobile 904-626-S664
Fax 904-777-4408
submitted: 06/04/13 07 :29ET Ope.i,-: VEN
bdbrs : CAB4S7 CCTV03 FLPS39 ipm SBF17
R.O.W. Permit Attachment of for
R.O.W. Permit# issued 20 Atlantic Beach,FL 32233
Owner's Name: AV-4Z �?;/X S11 —
Property Address: Xdirl yee,
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: 2FOL&CZ EFAGagG_ mw:�U�
WIT"_tFu) COKICIP�� Dphvlr=�Aq
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:
Kq 13 EAdA Pod e4,1 Ue, All,N-411C i3 Wit a ., W1 1315
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 I 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 by the USER.
DATED and SIGNED this day of \JR 20-6
By:
Property Owner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this day of 2015 personally appeared before me, a Notary
Public in and for said County and State, —7wt'r-9 P_4mo —, the property owner of
l4qf3E;4d:�k , 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.
VMALD
Notary lic in for said County and State 1 9"'.'P��I,:, AMY D BROOKS
P0 �',Ib Notary Public-state of Florida
My Comm.Expires Aug 5,2015
Commission #EE 114753
OF
CITY OF ATLANTIC BEACH, FLORIDA, a
municipal corporation: Bonded Through National Notary Assn..
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
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