2322 Beachcomber Trl row 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
r
Application Number . . . . . 13-00002934 Date 7/10/13
Property Address . . . . . . 2322 BEACHCOMBER TR
Application type description RIGHT-OF-WAY PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
concrete to pavers
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Owner Contractor
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JOHNSON, JERRY OWNER
2322 BEACHCOMBER TRAIL
ATLANTIC BEACH FL 32233
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Permit . . . . . . DRIVEWAY PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 1/06/14
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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.
Full right-of-way restoration, including sod, is required.
Roll off container company must be on City approved list
and container cannot be placed on City Right-of-Way
overnight . Approved: Advanced Disposal, Realco,
Shappelle ' s and Waste Management . )
Must sweep street clean daily during construction.
City sidewalk must remain plain concrete .
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
ENG REV BLDG MOD OR ROW 50 . 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 79 . 00 79 . 00 . 00 . 00
PERMIT ISCAPR9V&E1F(3%IX'0-IN ACCORDANCE W1LtH1AQ-0CITV OF A*5A4iTk0aEACH ORDINANC&AND THE FLORIDQO
BUILDING CODES.
CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND FA;FMFNTO,
800 Semphole Road 9G4-247-5800
Atlantic Beach t lo(Kia 3223�i.-s44t) Fait 904-247,5845
PLEASE SUBMIT 3)COMPLETE SETS OF PLANS WITH APPLICATION.
Date 3 PERMIT
ISSUFDRY THF CITY
Job Address
Permitee mi-ke '1&-4,A;1L,
r7" Telephone# q0 q_02�2 6-1��_5 3
Permittee Address 113C b0ac S4 1qL!)vSJ,,ve 3.20q ;Z
Requesting Permission to Construct. P-l'ifer Dir,-t—ov im ho, oP Conae4-c_
I ocation (Reference to Gross Street).2-322 i3egt(-WMiifer ccali,-
Tra 6 TbCC64- br. N-
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 I etter of Notification was mailed to the following Ublibes/Municipalities-
Jacksonville Electric Authority Yes P-1 No Date 4/2
Bell South Tek--phone Company Yes No Date 12
Ferrell Gas Yes No Date 6 1—
C .2
. M&-
Corncast Yes P�j No Date C.
2 Whenever necessary for the r;onstruction. 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 wres, pipes. cables or other facilities and appurtenances authonzea
hereunder, shall be immediately removed from said street or easernent or reset or relocated hereon as
required by the Director of Public Works, and at the expense of the Permiftee unless reimbursement is
authorized
3 All work shall meet City of Atlantic Beach or Florida De* rtment of Transportation Standards and be
perfonrred unclor the supervision of &4-�k_,_ 046L� (Contractor's Project
Superintendent) located at tj 5(. phone#:9&Y-414-5-3 3;2
4 All ma?(-rial%and equipment shall be sdb�ect to inspection by thel51rector of Public Works or his designee
5. All city property shall be restored to its onginal condition as far as practical in keeping with city specifications
and the manner satisfactory to the city
A sketch of plans covering details of this installation as well as a copy of a recent survey sfiazi be maae a
part of this permit. r-alculations showinq any lncr(
N)th thi- n i
I This permiftee 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 heron set out are granted only to the extent of the
City's right, fitle 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 attemptea
exercises by the holder of the aforesaid rights and privileges
9 The Director of Public Works shall be notified twenty-four (2411 hours prior to starting work and again
immediately upon completion.
OWNER
Sign. FILE COPY
day of-TVqv, b, :Of
Ja 3pe!:k-'12,0111 -1pla-'riled L
fie V- 1
N ry -tat ourty of Duva
U tf1';ai#nje,
ota P 4 a
cf�miision expfre
-_Pomonally Knovm
Produced Idenidlefton
LYN S�EVA
s #EE 1870�
Cropmirmes'Aip'
,%'Aw- EVELYN S.EVA
Commission 9 EE 187024
Expires April 5,2016
SWed Thru Troy Fain Inwance 800-385-7019
/ _3 2
R.O.W. Permit Attachment of for
R.O.W. Permit issued 20_ At] ntic Beach, FL 32233
Owner's Name: D16 ywso n 7-rt
Property Address: 2 -32-2- -gg"Wmkel
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 permi numbers noted above (copies attached).
This work is generally described as: �61) 6rff_t, 7-b -PAY-fiC.5-
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 an 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. I
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, ny 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 pernmmmn t 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 C7 243
By.
ner
Jd in presence of the Notary)
rope
to be
STATE OF ORIDA
COUNTY O�rl
FDUVAL
On this c--;)Y day of 2013 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)
descri�-r rd who executed the foregoing instrument; who acknowledged to me that he or she
x
th
e---e ---e the aMKfr(e "nd voluntarily and for the uses and purposes therein mentioned.
I �
A 7) Z 1V1'4 V
Notary u L a
" IM.
6* ..
w M ION if DD 957760
CITY OF
B0 ru a
municipal F
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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V1 City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building De ment.)
800 Seminole Road
�13
Atlantic Beach, Florida 32233-5445 '�IN'9
/V 8 Z
Phone(904)247-5826 - Fax(904)Z4:,:�L58455/ ?013
1015Q, E-mail: building-dept@coab.us Date routed: (01,2.5
City web-site: http://www.coab.us
APPLICATION REVIEW AND T ACKING FORM
Property Address: &M,6g� rl- Department review required Yes No
Building
Applicant: Al�J�f Planning &Zoning
Tree Administrator
Project: '�Iplc�O
Public Safety
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
A "
Reviewing Department First Review: F7Upproved. [-]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE ADM IN. Second Review: FlApproved as revised. FIDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: F-]Approved as revised. FIDenied.
Comments:
Reviewed by: Date:
Revised 05/14109
City of Atlantic Beach 11 1; APPLICATION NUMBER
eQ
Building Department (To be assigned by the Building Department.)
800 Seminole Road
-1UN 2- 2-47-3
Atlantic Beach, Florida 32233-5445 Z
Phone(904)247-5826 - Fax(904)-247-5845
Date routed:
E-mail: building-dept@coab.us -
Cityweb-site: http://vA=.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review required Yes No
Building
Applicant: /'V/�__4f Planning &Zoning
Tree Administrator
Project: 29 Flc_w__0_1�6
1/0 Public Safety
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 Departmer�t First Review: PApproved. DDenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: -.2-7-6
TREE ADMIN.
Second Review: DApproved as revised. ElDenied.
P C mments:
PU LIC UTILITIE
P. BLIC MSAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [—]Approved as revised. [—]Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09