415 SEMINOLE RD CLOSED OUT ROW City of Atlantic Beach e. APPLICATION NUMBER
Building Department (T be assigned by t I he Building Department.)
1.0
800 Seminole Road
Atlantic Beach, Florida 32233-5445 J
Phone(904)247-5826 Fax(904)247-5345
E-mail: building-dept@coab.us Date routed:
Cityweb-site: http://www.coob.us
APPLICATION REVIEW AND TRACKING FORM
FD—epartment review required Yes No
Property Address:
Buildirig
Applicant: Planning &Zoning
Tre 'strator
Project. (UNQ-W�or
Public Safety
Fire Sel)�s
Other Agency Review or Permit Required Review or Receipt Date
Florida Dept. of Environmental Protection of Permit Verified By UD
Florida Dept, of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restau,ants -"-.14
Division of Alcoholic Beverages and Tobacco 'A
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. F-IDenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:.4-'�' -n
TREE ADMIN. Second Review: nApproved as revised. [-jDenied.
a
'm
ORIKS mments:
P . J
TILI iE
(14L—IC SAF*TY Reviewed by: Date:
FIRE SERVICES Third Review: ElApproved as revised. E]Denied.
Comments:
Revielived Date:
Revised 07127ilD
CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
800 Seminole Road 904-247-5800
E)-_ Atlantic Beach,Florida 32233-5445 Fax 904-247-5845
PLEASE SUBIVI�COMPLETE SETS OF PLANS WITH APPLICATION.
Date
PERMIT#
ISSUED BY THE CITY
Job Address /.--A 0 Aci
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Permitee: U2--;P7 E 4- Telephone#
Permittee Address: Y�5- '7�
Requesting Permission to Construct:
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f
Location: (Reference to Cross-Street) �6111V)Je �\6 �Q_IZS_S' 6_Y)
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 (A No ( ) Date: (4 -116- 13
Bell South Telephone Company Yes No ( ) Date: 14- 18"-1-3
Ferrell Gas <Yes No ( ) Date: Ll- 1,3
Comcast Yes (,() No ( ) Date: -4- 1
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 ' �Q/f'�- (Contractor's Project
Superintendent) located at I 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.
a. 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 anV increase in impervious area on owner's lot or in the GitY
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-fDur (24) hours prior to starting work and again
immediately upon completion.
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Signed:
Before me this ival,
State Of FloiktIL PY,
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BP250UO2 CITY OF ATLANTIC BEACH 5/08/13
Application Tracking Individual Step Maintenance 14:28:41
Application number . . . . 13 00002517
Application type . . . . . RIGHT-OF-WAY PERMIT
Revision number . . . . . .
Path/Step/Seq/Agency . . . A 01 00 PUBLIC WORKS
Date submitted, resulted . 42313 42413
Status code (W . . . . . . BA DISAPPROVED
Reviewed by (W . . . . . . LS LISA SHOWMAN
Revised est cpl date . . . . 51313
Copies of plans . . . . . . . -
I=Add new comment 2=Change comment 4=Delete comment
Opt Seq Comments Prt Date
1.000 Provide table of impervious surface calculations for entire - 42413
lot (existing and post construction) .
2.000 Provide erosion and sediment control plans with - 42413
installation details and maintenance schedule.
3.000 All concrete driveway aprons must be 5" thick, 4000 psi , Y 42413
with fibermesh from the edge of pavement to the property More. . .
F3=Exit F4=Prompt F8=Log maintenance F9=Add standard comments
F12=Cancel F14=Required inspection maintenance