1160 Linkside Ct W Paver Patio 2014 *no permit required*".11. City of Atlantic Beach
Building Department RECFIVF
800 Seminole Road J
Atlantic Beach, Florida 32233-5445 FEB 2 0 2014
Phone (904) 247-5826 • Fax (904) 7-5845
~"to, E-mail: building-dept@coab.us
City web -site: http://www.coab.us BY__
APPLICATION NUMBER
(To be assigned by the Building Department.)
-ozy8
Date routed:
APPLICATION REVIEW AND TRACK NG FORM
Property Address:l1�p� �j� sj f �r a
!+�t review required Yes No
Applicant: � V E, -onin
di ;trator
Project: tly � r' --
1j �'�s
Public S,
Fire Ser
;Review fee$ - _
Dept Signature Vic_
I Puw .
Other Agency Review or Permit Requir Review or Receipt
of Perm' rifi d y to
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management Dist ct
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
Reviewing Department
(Circle one.)
BUILDING
PLANNING & ZONING
TREE ADMIN.
PUBLIC WORKS
PUBLIC UTILITIES
PUBLIC SAFETY
FIRE SERVICES
vised 05/14/09
First Review:
Comments:
APPLICATION STAT
#Approved.
V6
Reviewed by:
❑Denied.
Second Review: [Approved as revised. ❑Denied.
Comments:
Reviewed by:
Third Review: QApproved as revised. ❑Denied
Comments:
Reviewed by:
Date: e2/ / X
Date:
Date:
CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY
800 Seminole Road
Atlantic Beach, Florida 32233-5445
PLEASE SUBMIT (3) COMPLETE SETS OF PLANS WITH APPLICATION
Date , -?-!9-)4
PERMIT #
Job Address ---41 1 e W �` ` ,' f ISSUED BY THE CITY
_��L ;��� (+1
-�� c,
Permitee: I kn in'1 i2S o n Telephone #
Permittee Address: _ U L O L► a y,:,C J P C -L \All fA V-1 , -0-1C h
Requesting Permission to Construct:
Location: (Reference to Cross -Street)
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( ) No Date:
Bell South Telephone Company Yes ( ) No (r✓) Date:, .
Ferrell Gas Yes( ) No ( Date: 1 j;
ComcastYes ( ) No (J) 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 `�`c�5� U� 1 �1 ��� (Contractor's Project
Superintendent) located at ('30 (4 TT N, Telephone #: `�'0�5- 01115
4. All materials and equipment shall be subject to inspection by the Directdr 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 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.
• t
O*efols
�1
!)/>1 Date: -2
day of inthe County of Duval,
a pq sonal a ge tate l nda, o ty of Duvalp'Personally Known:
Produced Identification:
Notary Pudic Flrida,
Shirley ag My comnil
086990
Excirb 02MV2016
Permit Attachment of for
Permit # issued
Owner's Name:
R.E. #:
Subdivision:
20_ Atlantic Beach, FL 32233
Property Address:
Lot # / Block #:
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this
by Atlantic Beach, Florida, a municipal corporation organized and
Florida, hereinafter referred to as "CITY" and
hereinafter referred to as "USER".
WITNESSETH:
day of _
existing under
of
That the CITY does hereby grant the USER permission on a revocable
enter upon the property of the City of Atlantic Beach for the purpose
Beach Right-of-Way/Easement permit numbers noted aboXe (copies atta,
This work is generally described as:
20_,
laws of the State of
itic Beach, Florida,
described herein the right to
ibed in the City of Atlantic
Any facility maintained, repaired, erected, and/or installed ' the exercise of th 'vi ege granted m ins
subject to relocation or removal on thirty (30) days notice b CITY to the USE otice to U s 1 be
given by certified mail, return receipt requestedw ntol fo11R� d ss:
The depositing of said notice of cancellation in United S t s ail sr
(ute the notice of
cancellation and the burden is upon USER to keep CITY inform of USER rddress.
The USER shall promptly make any and all ne ssary repairs to any facility rected or maintained in the
exercise of the privilege herein granted and sha t all times maintain said facility in good and safe condition.
In the event it is necessary for the CITY the City's approved representative or other franchised utility to
enter upon the above-described property/f the CITY, the USER shall replace at the USER's sole expense,
any and all material necessarily displac9d 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 permV shall meet the current requirements of the City Code, Building Codes,
Land Development Code, and all 94her land use and code requirements of the CITY, including
City Code Section 19-7 (h) whilh states "Driveways that cross sidewalks: City sidewalks may not be replaced
with other materials, but mu be replaced with smooth concrete left natural in color so that it matches the
existing and adjoining sidewalks."
Pagel 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 requeEierl: o submit as -built drawings showing the change within thirty (30) days
after the day of completion.
This permit shall insure to the begeif 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 , 20
By: .
r erty Owner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this day of
and for said County and
and who exec ted the foregoin
and v t 1 and f r th u sand
(,
Notary Public in for sai Cou a
20_, personally appeared before me, a Notary Public in
State, , the property owner of
_, Atlantic Beach, Florida, known to me to be the person(s) described in
u ent; who acknowledged to me that he or she executed the same freely
Moses therein mentioned.
:State
CITY OF ATLANTIC BEACH, FLORIDA,
municipal corporation:
Approved:
Ricky L. Carper, Public Works Director
For Permits where city sidewalk is impacted,
City Manager approval required:
Nelson Van Liere, City Manager
Notary Public State of Florida
Shirley L Graham
My Commission FF 086990
46*0114 69/14/2018
Page 2 of 2
O ems_.
Graham, Shirley
From:
Carper, R :,<
Sent:
Thursday, , bruary 13, 2014 10:14 AM
To:
firegrll7@!.,iail.com
Cc:
Griffin, Mic -,el; Graham, Shirley; Walker, Jennifer; Showman, Lisa
Subject:
RE: Paver r.;rmitting.
Categories: Red Catec ,.y
Cheryl, you will need to submit a regular building permit application for this work, with a sketch or drawing
showing the proposed work. The application will be evaluated by City Staff and if the added impervious
surface is less than the city threshold, then you (or owner) will be notified "No Permit Required" (please
include an email address or fax number on the application, otherwise notification or requests for additional
information go by regular mail).
It=
Ricky L. Carper, P.E.
Public Works Director/City Engineer
City of Atlantic Beach
1200 Sandpiper Lane
Atlantic Beach, FL 32233
rcarper(a)_coab.us
PH: (904) 247-5834
Fax: (904) 247-5843
Florida Public Works - First to Respon(. _ast to Leave
www.apwaflorida.com
From: Griffin, Michael
Sent: Thursday, February 13, 2014 10:04 AM
To: Carper, Rick
Subject: FW: Paver permitting.
Rick, please respond to Ms. Castro.
Thanks
From: Cheryl Castro [mailto:firear117(-": mail.com]
Sent: Wednesday, February 12, 2014 i-56 PM
To: Griffin, Michael
Subject: Paver permitting.
I'm looking into replacing a concre-, -)ack patio with pavers and extending it out 3 feet while also adding a
walkway. I need to find out what I need to due to obtain a permit. Please contact me back at 904-307-7878.
Thank you, Cheryl with JD Pavers.
FROM :
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