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2233 Seminole Rd # 17 (vault) CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD - ATLANTIC BEACH,FL 32233 +� �J INSPECTION PHONE LINE 241-5826 Application Number 06-00032499 Date 3/28/06 Property Address . . . . . . 2233 SEMINOLE RD UNIT 017 Tenant nbr, name . . . . . . NEW BALCONY Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 5000 Owner Contractor - ------------------------ ----------------------- J. , N. SAGER & TIMBERLAND CONSTRUCTION 4131 S . UNIVERSITY BLV 316 3RD ST JACKSONVILLE FL 32217 ST.AUGUSTINE FL 32084 (904) 545-6275 ----- -------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee 55 . 00 Plan Check Fee 27 .50 Issue Date . . . . Valuation . . . . 5000 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- -- Permit Fee Total 55 . 00 55 . 00 . 00 . 00 Plan Check Total 27 . 50 27 . 50 . 00 . 00 Grand Total 82 . 50 82 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. t' BUILDING OFFICIAL NOTICE OF COMMENCEMENT State of +r-o a( r)4 Tax Folio No. County of 0 iiyAr L To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT- Legal description of property being improved: tl ,v i 9 r 2 'z-,7-7 S'c-r� l iva L Cl rC 6 ,tj 3 LL- 7,/ Address of property being improved: Z 37 St:--YvtI ve General description of improvements: ['2 X Tv 174 Ru w ' K 6v,V,1 6Ve-y4 Owner: 04414 vtki AvVIL- SLOE E-& Address- 114 Alt V- ZZ 3-2? 5L ry'1 , c{ Owner's interest in site of the improvement: 0 wwek- Fee Simple Titleholder(if other than owner): Name: Address: 2 S �'�+ �nia r=" 77 G / 3 2 Z 61 Contractor: Ti rvl 6t ryL C.4, A ow j j LN 0 r�yJJ Address: ; t 1, 3 rL_o S S ^V( jC4 7 2- P `�N, Phone No: �lL)4 �-Y5 6'L7� cl Fax No: e Y e1.� o yJ � Surety(if any): Address: Amount of Bond Phone No: Fax No: Name and address of any person making a loan for the construction of the improvements. l ' " Name: Ad—dress: P-=ctne No: Fax No: _ Nar-jq of person within the State of Florida,other than. himsely, designated by owner upon Y*,I;m notices or other docu='ents may be served: Name: Address: Phone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in -- Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option). Name: Address: Phone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1) year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER Signed: �thiij*h '�J ...C>JL Dater Before e day of Ho,\C in the County Doc#2006107294,OR BK 13159 Page 1221, of Duval, State of Florida,has personally appeared Number Pages:1 f Filed&Recorded 03/28/2006 at 01:35 PM, Notary Publi at L of Duval. JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY My commission e KELLY L.WAINWRIGHT RECORDING$10.00 Personalty Known Onai(SSION#DD418897 or Produced Identific F1,Not r = CITY OF ATLANTIC BEACH Cc: s f BUILDING/ZONING DEPARTMENT r� 800 Seminole Road S.Doerr Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # �& - 3 Z�g g Property Address: Applicant: 1 i/Y�t>Cr � l-n r� t.tS115T�I�p'ri M Project: A This permit application has been: Approved Reviewed and the following items need attention: CSC �r Please re-submit your application when these items have been completed. Reviewed By: l Date: Date Contractor Notified: �s CITY OF ATLANTIC BEACH `= BUILDING PERMIT APPLICATION (Alterations &Additions) Date: 3- 7-,0 Job Address: Owner of Property: . SSLfGLJZ Address: 2-7-5 3 /eo 44 17 Telephone: Legal Description: Block Number: Lot Number: Zoning District: Contractor: -rt 14/31!5� LrI1vo C ✓1 i Tn/C State License Number: C-4ZC 03,T5416 Contractor Address: 3 C �'Za ST_ Jj .4t/41- Cl 3 2-dkyr Telephone: 90Y S f Z7 r Fax: '�1' G y ��ZJ" U VJ_7 Describe proposed use and work to be done: u/I-V , v C A 9 r X/6 LG0 Vy C)"-,k h % y ` V' Z,' ' 447-/ a Present use of land or building(s): C O*✓o d Valuation of proposed construction: 5 ,00 -0 Dimensions of the added space: feet x feet Will this project involve: ❑ Heating&Air- ❑ Plumbing ❑ Electrical ❑ Fireplace Conditioning Is approval of Homeowner's Association or other private entity required? If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% or more to the orininpi imnerviow;arQa or the removal of any trees? [�]NO. Applicant certifies that no change in site grade, impervious area or fill material will be used on this project. ❑ YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. ❑NO. Applicant certifies that no trees will be removed for this project. ❑YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -bttp://www.ci.atiantic-beach.fl.us Page 2 Revised 8/04 HP Officejet 7410 Log for Personal Printer/Fax/Copier/Scanner Information Systems 904-247-5845 Mar 14 2006 9:41 AM Last Transaction Date Time Type Identification Duration Pages Result Mar 14 9:40AM Fax Sent 819048250457 1:09 1 OK In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. i. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. Address and contact information of person to receive all correspondence regarding this application(please print). Name: DA"vl b F6'L TIC IPL Mailing Address: 3 l G 2 i L q S i Sr AV C v X Y' Telephone: CW YYJ_ C t 7f Fax: 9 U Y d'ZJ_Q YJ`7 E-Mail: I hereby certify that I have read and examined this application and attached documentation and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with,whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Owner: —Qh Date:3/'/Q(Q AS TO OWNER: Sworn to and subscribed before me this day of � ,20 State of Florida,County of Duval ii�my KELLY L.WAINWRIGHT Notary' Signature: COMMIsSION a DD419897 EXPIRES:Apra 14,2009 Personally known ❑ Produced identification Type of identification produced Signature of Contractor: ;` Date: i AS TO CONTRACTOR: /p 6 Sworn to and subscribed before me this day of 11 ,20 State of Florida,County of Duval r nn Notary's Signature: - KELLYL,WAIN GHT t My C0M)vt8810N1 14.2009 personally known AS3= ❑ Produced identificati sod3lor�v Type of identification produced 800 Seminole Road .Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 .Fax: (904)247-5845 •http://www.ei.atlantic-beach.fi.us Page 3 Revised 8/04 4q.A i4, •iJii� I' Nil ; � :I ', " -- PUBLIC; N011C E The foregoing corwttiusa line! aqann y atton. Any person whose..ubstantial interests are alfeclttd by eny door&'on , made by the Deparnnent an Nte Fietd Permit has:hi rght to request an ado rinimistve htiaring in accordance with thf, provt#ktn&Of Se00 120.369 and 120.57, F.S. The request for an acirninistrame treating must comply with the P;ovialone of Ruin 2B-1*201,F.A.C., and must be rece'ved by the De,;artrr.sni iat the addivsa given below)within Mrerrtty-one(21)days from the date of this nor'ca When tnwe Aep Mrwt fVsrivos an adoquase and t.mely filed requ=st for hesrin , the �epertm#nt will req ed ties I se#ignmont of an administrative I*A, lunge. Once the ,#ami�iat�a�ivo }pw fv to raQuwted, the Division cj Admirdstndlve Havirings will have h°dsdictlor. ovbr the fortrai procse,_;ng and E~pg Drtm m (as ±:ale refertN agenty)will take no further acvcul)w Oh(aspect to thq;M0006ing.erCR?Xas a patty litigant,A—L i t Section 120.64(5)(b)4, F.S.,and Rind n-?mv,(2), r.A.C., ixplajn that:tip tollowir�p items must be included In a petition for#formal adrrtlttistrittive pracmedirtig. (sl) ?ha AVme acid addAl"i of and ea..;iegency'e file Or idanf tcAtfonilun"r,If known. f (b) The nemwr,oddresiL and;*im0tonn-number:if tr,a py;:%ter Wa na;ne,aiclMss,and tale hone number of vie petluorikies,mpresentnuod-(ff Jn$ iuht01-011; be tne'addG dreoa-tor service pLopoew ,x the codrea of the _ g, etmoaey�tn an a ttartattiot o, TT how aha ur3gner s,substantial interests will be..affe�rtad by the agency` i V tlitttatf A state nt 9f when and r1ow;fha p@(itioner receira.notice of the agency w9c�ion. - �jaytJdarnar►i of all 44606 of maeral pct disj:i,tea eye patittcner,qr aaterrtp rt that tltsrs gra rw dls;�iiteii (e} A co 4m#lederit#nt of#V uftrnat@ farts including a statome' of rhes tic fllchs tttart lite p®ti�Orter corilends warrant reMeieat br modtA tion of the D,#Vprrtaent's action,r' - �.;.� m j . A # nsont of the &pacific ru(eu or statutes :he petitioner zontanou req,jae rurers2l or modification of the �• Oa rtnt®tith Jgotten,Tpcir lit ;art alptan&pon of how the.41INNed ftaes relate to the speck n lee or s�ttrtwas. 4-,4 ._A�ttatemarlt o!t<t� rbllet tOtXtit;6y" ri petit I*f, stating precisely the Hotton that the R6111oftr waarris the Daparrimailt to tato#eolith respect tc its taction. A plfiauxt''my rarquerrt an.edenspob of•t6e to petitidn for an adr71ipis1rativ6 hearing:U*.pail;W tiling the rgquest fon extorsion must dd rut within the time limits f0f filing a petition dos;rbea iYiwve 7?.e request mt;itt &hrte why an Wdension is needed.The Department'will grant an extension only %hen good rause is dhow'#. If a-potition or a request for extension of lima is filed, tursher order of the Uepartment bermes rtecas&ary to effectrtate"a F(sM Permit A";Qrding y,d*pepartrnenrs final action may be different from TO Pcwaon totter,in heti 11 notice,Action#und#rteken by any Gerson under this permit, pending the tapw3t;of tune allowed for the tiling cf such a requaat for hearing,may be subject to rnowc*tton;removal,or restoration. Piiilure to;lathier;within the aitowed vnte tMme Cortititutes waiver o!any right'that a person had faest a ha ►e9u armg 1 u vkr Section 120-57,F.S.,seta;o participate as a party to the proceed'ng. 1 a lagatly sufficient petition for hearing br not tkT4y received,this notice consbwtes Ansi arrancy action. When this order bec:ornas flint and is flied with the Cb•ortm-^l Clem;, an � a p3•ty :o the orCdr has the right to seek judicial rgvieej unser Section 126-57, F-S.,and R:!e 9.030(b)(1)(cj and 5.110 Ftorda Ruies of Appellate Procedure. A nour.a of appeal roust be Riad%vithin thirty(301 da)s with both the Deparu're t C*rk (see addrew below)arta with l theappropriate district court of sppeat. Th notice h cd with tris dwetr,cl i.arart rluat tee accompanied ty the flt.ng fes apecified in Sacilk)n 35.2213),F.9 Any sub&srgttenl wtervention wdl oe oily,✓y'he approvai of the presiding offlc&, ora motion flied;older Rulas 713-6 207 or SOC-2.010,F A C. All Mquestt for ha#rings;at*to be filed with the Jepartmen:at the following atodrtvo; Florida Departmmt of En iforimLwtai Pnjte,Aon O lee of G ineral^ounset Drtment Clerk C mmornwlth 8qudgvard l �" fiwl6tl$t#tiOA 35 r • . r Tal thasumFlorida 3239g.-3000-. i PERMITTEE MUST408T PERNMANO PUBLIC WOTICE CONSPICIOUSLY ON SITE ! DEP Form 73•!22•(ittvised3i0S} • -.•.:. . _�•...:.,. ...., ..a...... _... --. _ . . _-.... ---- -- � t lr i :47FN " C F°ARKS `:'" `''1�-1�;�-0 � r, Phar, i 210)6 roxNTA1.FROTI-C"ON no UIM nEPARTWrrr os ENY12toN11�E Bureau of beachca and Ca+sal SY,d9" pa,wrir Naaisr -8020521 t 3900 COMMawealth VIA-MS 300 �� A Tdlahasatja.FL 32399-3000 Na 4/pdS"Atdocb@ -- �f Phone:(130)4117.4471 ,p rg pMIJAW TO SECTION 161.953 or 161.052.FLORIDA STATUTES t w...o..Kiwed by the ttaC dWrm of the LXV& tent Of IQiDII1(i0 O! !AP?AltlD ap .lIB60![lI OF LAW: Tho nagYaR icx a p 62533.Fbsida Adiast vW6v%Oodo(FAC.> AW-d is Hn�tonnstal m and*mWb be in owmPlm oo with the nquimn"ls of C VW 1 (L�YX aaa.W tlllndatd oondhiona,and ay medal $cadthe wtvity j,d,MW Iloo'di°"s'ad by MU 9�ff"b•awpa dod a rwak.+is.aoo++u+ao wtfi S"M°"62' b 4.100.FA.0 plKwtcr 055ca"awo a ap�i+osblc federal.saw,aad 1"d pow&meblAmw VA don not mt#Niw SF2C%L rULI> r coNan wi/; 1'kia psslnit is valid only 'hhi�aPw Wk noire IW to po*d as tM is 4uamwY Ww card Wmdon of ytarl t�atbaoit tgtitatWI* err tam or unto tow mmodion of MY act by Itis PPi t Odwr IPOW aoOdit m of" i WAM and*hall ransm t i wMb local epltravd permit indudw r sTAIfDA>RD Plat IIRf CONtDftfON� Th,p°"rr'rtac studs oc WM the at a*W�fwd Paoert oondit CM TONit I gttt I atn sitt►ar 00 dw mmw of tis* (Ib}I have iL ft.CO RtY,Oronewd to weer AlrL1CANT IIr/D1t11sA tarbls penes or p.rsm0==-w by a aosfs,musty.a ttun+ic+pd this pesnit on the ov+nals I ahatl obtain aQ tat tm auti�Orirsd wont is what I"quer rd;mW(4)I siert mpo bW fw law ptiot to oomttroncatnaM, ootnppanaa whit au - �'✓ Data d /6' Lf` Talaphan•)wio i/ L ] S 4/1 Z 7�1 Applicant'■S "'"--- % G ?Zd•d' Appdcant's PritetadNaaM /'4 �--L-� _Addis J I ,� 3� ?,,y ..S - C- lrqq auK ism molt ores ! p �owra r p1 110 ° W. wars ayrlxp►0' _ an bdwt'of tbv Dequarom of DtPAR?MSNT SAL Aa u wQdoa0»�Mod a�i� � " I20.5Fj,wills tho Uadwivad doftrmdia ,IlvbDeputy clot, i t of bit_ k hatrt*r paputy Clot,tabaspt E GrZS 6 A/—IZ6 N� PUBLIC NOTICL 0 a TNR RACK OF nW PZR Wr- gXpIRATION DATit �, sero ae y m saa8on t*�8.33.014.FA.G..ars valid for no rnaro than ttitaty data and o$ar t u 12 D.wec�t�Y 4o'a shorter tent ' ' ) ,,��,,//►► ❑ w EMMICY pl�T:C3YFS No Appwvad Ptaes errs atttn►ad: WU � AND pUHLIC NOTICE CoNSpicwUSLY ON THE SrM DBP fotan 73-122(t3pdsad 3103) �►L`�Py'TaNu4sens D,�ior1 �'��C�1�`Arp� l�C,9P)' J aFFICIAL'R � 'J1tJNTAC OCt�11 ?' a . . yrF rfu�ra+nftr �+..� !!fin' •.• . „.� - flh...WNW A/ "Ifd •.�. i'•• •�rwr:r.v .rr��"• " •. 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Irw•„V.•Mv.•-•.wra•arr•�N/f•�1.•rr�••ararY lrr yrear.►PI•r...�.�..war rOM.•1 r.�N(M ICYr�(rrr rlw.�w�r>ati'•' y�.•alya11.11W(l/rliaAr Y�.\•ar Ar•rrlhf •✓.i..n..�wr..IAw.wYrlw�.MC+•wrwlwrrti.towq.a1.,rI.Mr..1rwwlrwrT�sal.rtL�r11(r.a.r�lArrWw(•.•op"we�.Mrrr•1!'(MM••Y� _,. w'•r....•..w.r.•...w.,w.fau ww..A.waara—•..�•w.r.rVq rl.Y 4peo yr•.Mr.af1Vb rPr:h.w. www.V•.a ✓r r•w s•aA�w•ara awal(a IYNaY.r rw f�r�-as a/•r M••'aif Ar W.waf../•Yw r.r/r(rw�(+I M PP07f�rliA leg"A raNw�.•r+••+l wr .vr s/r11�/r1•r[li Y.,tw ar YiXIUBI "VI':� .' _ p-• r Z@ 39dd 6E9E6VZV06 LV:ZT S00L/90/0T CITY OF ATLANTIC BEACH cc: J BUILDING / ZONING DEPARTMENT ri 800 Seminole Road S.Doerr � - r Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # Z- Property Address: 3- SLS/I7/ d�� ZI 7 Applicant: I iM b Cifl-C4 Project: /V This permit application has been: UI' Approved Reviewed and the following items need attention: Y Please re-submit your application when these items have been completed. Reviewed By: DSO Date: Date Contractor Notified: CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION =~ (Alterations & Additions) uR19" / Date: 3- �"0 6 Job Address: 17,33 Owner of Property: Address: 1--2-3 3 SCm i N e 4 is 20 #1 17 Telephone: Legal Description: Block Number: Lot Number: Zoning District: Contractor: -"/✓✓146� L,4 ✓mo C`,vJ•r rN( State License Number: CWCtJ-UY16 Contractor Address: 3 Telephone: jOY S 156 Z7f Fax: Ll 6`{ �'�� OV -7 Describe proposed use and work to be done: ^o, A 9 t X/C f /34 L G©n'Y 6V4-,k Present use of land or building(s): C 0'✓,0 a Valuation of proposed construction: S ,00 .0 " Dimensions of the added space: C ( feet x /6 feet Will this project involve: ❑ Heating&Air- ❑ Plumbing ❑ Electrical ❑ Fireplace Conditioning Is approval of Homeowner's Association or other private entity required? If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% or more to The nriainai imnPryinnc-Area or the removal of any trees? g'NO. Applicant certifies that no change in site grade, impervious area or fill material will be used on this project. ❑YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. ❑NO. Applicant certifies that no trees will be removed for this project. ❑YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atlantic-beach.fl.us Revised 8/04 Page 2 In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. Address and contact information of person to receive all correspondence regarding this application(please print). Name: d A Vl n Pa/L7'C t'L Mailing Address: Telephone: clot ;,-'7j'- Fax: 6)t)'( t2 f_0 YJ"7 E-Mail: I hereby certify that I have read and examined this application and attached documentation and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with,whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Owner: Q� Date: AS TO OWNER: Sworn to and subscribed before me this day of 200 �l State of Florida,County of Duval KELLY L.WAINWRIGHT Notary' Signature: MY COA4tlssloN M DD418897 EXPIRES:April 14,2009 Personally known 10 3.NOTARY fl .Nomy Jnr Asm Co. ❑ Produced identification T�e of identification produced Signature of Contractor: Date: r AS TO CONTRACTOR: 20 o. b Sworn to and subscribed before me this l day of State of Florida,County of Duvalj Notary's Signature: • LY la,W GHT M�comhossloN 0 D EXPIRE: 14,2009 Personally known NoraaY n.Nomr rim AUM CO. ❑ Produced identificati Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atlantic-beach.fl.us Revised 8/04 Page 3 \�� + -irri ��gfA►•�'�..!�1�1�°�. ..d,t►..j�•�r"�.`)jd Y���Y�.��i. •i e_i ».rP', • . , i '` Lt T ,Cl� ti' Of . . ON'AS F IC1ALA ll rig c y 5C� ? y�H wuI wr VI. _., �� '.?•+-�. .. (sg t7� {�(Illi�� 7 r• .�tl. L{ ,tel 1 J T... opoj N. � •• i, •� �ti611NN�/Wji�L ,fit • r...r•..r v{ 1d' - � �� • � A•.���r•�•r•rte\� 7 S.dL•--��.•t,• rf �I..i •In, � �'+, - 1 � :�1• •rl J•�fC ! LMJ4oLdt. ,A PAA. �. •. --- bar M d aa :►f - d..r.. Ati•Ir•.••n1A•N..R•1n.n•+tr.My1•IN Mt rr�.tJF�•I•It�Rlt\1t\►t•.YIN•Y Mrwl'.N�r•A•�ttt••t t{l•". '. �. . r•wrW�r•"r N•.•A•••r.rr••�,M 04+r•Mta.Y.rf Y.LNrt••rr«....aw�:�'u:1w�srr•.wM Yi.�iwrw•..�•'.�. . y r.•r M•I l.I ld/!l t•t•tA Y tr11 r•�AI•MNJ twt.•}�t��IAA•r t+rq}M - •�.i••n•.•terr.AA••IwY ••.•t•C•rwr••�••..t•wtt.1FtW1•two}•+•t'fr.M'rVwd••N•N4f ttM•►t94 v:to•s WWalY •.•r:t•n•ttM sn'.+•......rw+�•�•.r+••�wrir.i�i�rr.rary~•�''+K'wrw �nJMMtfli� i.I r*Mfs�wtA Mt Y�it.411�O Y- r�Nvt.'e iw..'•".d w•w.tea-.�,/t rPA - n u:;:• ' .♦ Y,• •,r r EXHiBlT •.D 66966OZOGG Lt+ ZL S20Z/90/0L Z 0 39Vd 7 T PUBLIC ,NOTICE � t l the toregoing cortstuts a dine!4ancy aulkn. „ny persen who6a suh"Adrifal interests are affected by eny decl$'on made by the Deparlmrit or,the Field Permit has.rb r;gtit to requtsst an adminisitativu fidaring in acaordanc,3 with Me nrovtalons of SoctfoA 1+20,569 arxi 12b.37, F.S. Thb r;:oqubst for an aarninistrative hearing must oompty with the i p°ovw1ens of Ruts 28--1,16.201, F.A.C., and trtutt be rect'ved by the D4yd{1~reni 41:the addrasa given Lelow)within twernry_one(21)clays from the date of this notice When the Depar'mn't rer Kvs an adoquate and iimety fr!art request for hearing, the Department Will reqs" U% eesgRfrrfnt of en edrnctlatrEtnre le'N ;UdBe- Oncet,'re �d(l!'.$t AtIV18, (3Vu t{; ' rs tequestrad, the C•{ mr, c` - AdrrtinlstM ve HeWings will h Ve ft;risdictlor over t)ie f6ttra{ proceeiz.ng and M Department (as rze referrhv agvu;y)will take nc•further action Wolri ja'" t to the pr,caeding,axe@o{its a path Mogan Section 120.54(5)Ib)4, F S.,and Rile�0-x.06:�U i 12), r.A,C•, explain,lr.at :lie following +tonic must be i7cluded in a ' petition it a format adrrtii:istrative pros eediN. (a) Tha fariea aril adds"of gioh,ogendy.ofiwiad and eia.i agency's;•sets or irtntificatioitnumbar,if icr,awn. (b) The namt,addre3d,.ana¢rtepkturia number-.if trm pw,?nor. bier na ne, idc mssi acid tele none number of tie11 petlticrfibed'rspreaenfabod-(1f iny); vii 0- 11tV be tne'addieee for eeivice puy`pom duriftg the cotirse of the f 1 brace ngp; th�on e*le+,a0or, 01 how the oetitio,ar's substantial interests will be.offe:W by the agency`. 1 (C?, A stallm.1ni 9f whan and h4w,the{p@titigner receiy�i notice of the agen;,y 4 ion. }y�staittrnerit of all issues of maweal Oct dtspi_,raa oy tie petlttcn&,r. or a slatemerr fttat fh`re ata no dis;xatcuf (a) A conolft stdtttKl Wt of tre Arreta facts etdcyed, inciud{ng a statenfe-t:,f mist specfic facts thstt the pe6iicrrwr coidends warrant remwtn t br utricle at'on et 1 gc Duct;rorwts ocUor r' _ (f) ; A. sltetpment of the spscific rule of atelutea :he petitioner :;onttinars raq-.sue reversal or modtf"tion of the Dtiigrir b+0.1h fiction,ittcG:dirk a t ei<piari8tlon of flow the alleged facts relate to the stticb1c r 1ss or fita"os. A ;tetsment of 1 6 ral'aef todgtSt_br t',a pabilprie r, stating precisely the action tliat the Fe�titio+•ttgr wants the bip'Wtment tru is"Ah r6api to its acl&. A;eiwon way rltgtJedl an.ederi5ir3i)0 16e fp pelltidn for,art adrtt Gistrativ6 rwaring.T*'PWj1afi long ti'ie(@quest Por wdersion must ted so within the time limits icor filing a petition dos3&t ., atwve Pe request mu$d $tate why an e)densiori is neroded.nis Department will yreant an extension omy .%hen g,uid cause is tahow'+. !' {f a patitian or a request for extension of tame is filed, turther orJer of tht OeperUnen: becomes necassary :o offectaste this HM Permit.Ao(<ordingly,the Departrnent's final acticu may tie different from ire position War,in tfda noir A,ACIipns ondrrtatker by any wson under t.`vs perm!t, pending the Wpoo of time allowed for the filing cf such a req,aat for hearing,may be")OCT to MadfflU110n,removal,or resWlaiion, Failuro t-� patilior, within the allowed tfmi frame 9onistit.itas waiver of any right that a person hats to requatt a hearing j u.73er Section 126.67,F S.,end to participate as a party to the prodding. V a tegaliy s0ficienl petitlon for tisarrip is not hrnf y rece,ved,this notice oonstiwtes final 40anry aaticn. 1 f 'Niton Ltiiat ort;er bet:ari&s ficial an�f is OieCl with lite f.bparim:-.•:t (italic, any p'+•ty .0 tris order has rho hgt+f to seek ;udlcrai r9wevi unser SZW. on 126 57, F.S.,air,.d R,'!e 9.D30(b)(1)(r.� a{'d 9.110 Fkn,aa Ruies of Appellate Piucedura. A=ne of appeal most bo clod within thirty(0.)day's with Will the Cepa+t,r.ent Z'*rk (se*addreca below)ansa with the arporopriafe distrwt:ourt of sopeal. The notic$ fi'ad with tt,a dist 'G i,ouri i`ivat to accompanied ty the fil!ng tea 1 apecifietl in Seo tun 35.2213), F.S Any asbs6`quent rtt3rventi0ri will rye only ru rhe orprovai of the pregld+ng offic6r on irictlon Fled 4rider Ru*s 26,-5 207 or 60C-2.010,F A S. All requett$for heeringg oto to be flied with**:Department Of tris fGtk wing a+odrr�rita; i Pt nda Dapairtrient of Env ifoil ri 04i Rr',DI ;Wn j tin es of C�arierat:ounset Dtjwrtirnent Cie* SM Carnmtanwoulth Nuievard i !{+btt15tael6n 35 Ta0haysK,flowa M99-.3600-. PERLMIT"fE]E 1V;tUSILP+RS'T PERMIT AND pt!E,i.JC NOTICECONSPICIOUSLY ON SI'f'E '. n7l '�COFEWRONMEN`TAL PROTWnONFLORID►DRP�llYfMM 3urenu of b esandCuna+slSYA's" POMN Namow.3900Co"Mnwealth Blvd--MS 300 FLOTallah�s .FI 3239SI-3000 Na q/PWAnacbsd -- Phonr(S50)4S7447! FIELD PERMIT P1JI�li�TO 6ECi'ION 161.063 or 161.052,FLO�ST��1),�.p�a„a„t of (70IiCLUBWNS d1 LAW: 7ha rayuo�t Sort pantit war aoMaidorod by Codi(F p C.} 1 W-,'aI r lIIVAW�9 Of 1AL"r Ar1D to bs bw aompy+t�a with the r6quiretnonn Of C1ui 623.33.Flo�id� °1�' mors,u++d+a)r�°� FIIAMnm=W Amabatsan asd*mI m&�took WA by Im P-*-t dwcap�.a4PfOvd Dteru(�afly1.��two wifi t;Mtioe 63 may to the a�sirity I61.0S3($1.Iuida Stavros- Tha y„�t Miley bo auaptnbod a rw+�d .OW,Ww awd hebw p,asoant a P+aW* raon'CT LOCa1110N. tit pEsC11Y[1ON. t valid on17 a god". ".�tL vw pubi notice s�11,UW iced�b�V°Aod OdW,�,pal��'��'ef UPM SPIiCIAL?S0 I 06 objMW La dm mA soft= CpNNMCIONfI: Tbia permit ��"''„"'`” OW sof mw wawk i+ssll pww"**am** �►�&1 unor w mph'm s*r activity '�d by d�i1 pomiik parI iiwudr. ---- P"A --._SW� with the 61�n�Sold WKS 000dition. STAIfDAI;D lBl;llitt CONDrrI3: The posmittac a tM owner of tiff oat Pr°PMy$1 (1b)(ib)I he►e tl�o arrnero county, or to asw* DrlOR MATION1 I hm tpot I•m dtinar (I it) M raiukw by •surae.county,or i mthis on ft owme I thtII obt► t MDDo �*at the&or pmm uootrdy and(4)I seoepc r w burly s trlulf. ukn wthaead wont>f wMl I1 I,w;niw to t (. 30f L� rnra-r aIII(�aF w- if Tehom Appiauxas, - o �j! , fJ" S % Appliques tedC trappumal &&wit a+Mpr. aA �zWd— . ,uw �i s IiEPARTM1cT� MAL ACi7)N AND VajNG AND ACKNO'WLEDGMRNI'a T"u &k W i' �u od ca bow of ttK Dsp►tttt�of Euvtmmnn.!Ptaowdm b� to(,&MWwd� 0°' fdod oR thin dan,p t b act:Ow► 17O.S2,F E-,`►+ tho u Deputy Ctarts,xWo of haa�y actt9osAod�ad �.+ �0• m,.noN DAM pUsLIC M�a wO THR BACK oIr TMS FIRM. to section 5213'33.014.F A C.,aro vaLd fix no marc than trirrrh'dM thu 12 W* t}IL ItIC t � opwify i shmorwwr n�.•� 4 } ' ONO gJ,,1g,A(�tiCY) : L� �� Nt7 A�pved plant WI�BaOs d AND PUBLIC NO'T'ICE CONSPICUOUSLY ON M SITE DEP forst 73-122 ojpdated 3103) v c,,y.Tglk+ri W.of l