375 4th St Driveway 2014 CITY OF ATLANTIC BEACH
y 800 SEMINOLE ROAD
`J
r� ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
JF3
Application Number . . . . . 14-00000536 Date 4/24/14
Property Address . . . . . . 375 4TH ST
Application type description RIGHT-OF-WAY PERMIT
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 0
------------------------------------
Application desc
paver driveway
------------------------------------
Owner Contractor
-
------------------------
-----------------------
BENNETT, STUART N & PHYLLIS W OWNER
375 4TH ST
ATLANTIC BEACH FL 322335343
----------------------------------
Permit . . . . . . DRIVEWAY PERMIT
Additional desc . • Plan Check Fee . 00
Permit Fee . . . . 35 . 00 0
Issue Date Valuation
Expiration Date . . 10/21/14
----------------------------------
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 .
Existing concrete band between driveway and edge of
pavement to remain.
toration, including sod, is required.
Full right-of-way res
If used, roll off container company must be on City
approved list and container cannot be placed on City
Right-of-Way. (Approved: Advanced Disposal, Realco,
Shappelle ' s and Waste Management . )
Street must be swept clean daily during construction. -------
-------- --------------------------------------------------
-----
2 . 00
Other Fees . . . . . . . . . STATE DCA SURCHARGE
ENG REV BLDG MOD OR ROW 50 . 00
STATE DBPR SURCHARGE 2 . 00
UTIL REV MODIF OR ROW 25 . 00
------------------_---------------------------------------------Due
Fee
____ ----
Fee summary Charged
Paid Credited
_ ------- . 00
----------
- . 00
Permit Fee Total 35 . 00 35 . 00 00 . 00
Plan Check Total . 00 nn n(�
PERMIT ISgfiP 'EIV®1�LYT{� �ORDANCE WIT719ACMITY OF ATLI�IP%EACH ORDINANe-WANDTHE FLORIDA 0
BUILDING CODES.
CITY OF ATLANTIC BEACH
s
s j 800 SEMINOLE ROAD
J �r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Page 2
Application Number 14-00000536 Date 4/24/14
Grand Total 114 . 00 114 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH APRR
CONSTRUCTION PERMIT WITHIN CITY RIGHT101WAY"A M S
800 Seminole Road y 47-5800
Atlantic Beach,Florida 32233-5445
PLEASE SUBMIT jCOMPLETE SETS OF PLANS WITH APPLICATION. cay
Date 4 ,l� PERMIT#
ISSUED BY THE CITY
Job Address ' /S h SIX�2�i 11
Permitee: EX-j', ry)cf AgaosCapeS oACJ-A-c Telephone#
Permittee Address:_13864 �et�e N T �WPSVV'Q, w s-
Requesting Permission to Construct: 12cw6yE' cckt (W f e Dy-kye
Location: (Reference to Cross-Street) � (�✓li�
1. Applicant declares that prior to filing this application he has ascertainedthe 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 ( ) 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 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 (VX LL tin O�i (Contractor's Project
Superintendent) located at 131d34 r, IX0, 04, J?W._Telephone* 5c15.724
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.
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 showinq any increase in impervious area on owner's lot or in the city
Right of Way are to be included with this applicatlon.
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.
S. 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. o�,�Y PUBS, Or�-- MY COMMISSION#FF 027076
OWNER �'I * * EXPIRES:dune 13,2017
Bonded thra Bud�ti Nolary Services
Signed: Date:.
Before me this day of lin the County of Duval,
State Of Florida, has personally appeared
Notary Public at Large,Stat of Florida,County of Duval., •
My Comm issio, expires: UAI�- 1 i _
2/)i Personally Known:
Produced Identification:
m � 4 ti
Y
U
o • per
C13
N
Y
UL O
4z -�
=F= .QQ.CQ.SO S �� ���� Zsyi
0-C (1y-ld) ,00"091
(a3?3nSd3y4) ,00,ogE 3 ,�[��0�.50 5 a
x in CL
O
o-
zo =
7 z ai
Ll
co lilW
r - Y na T ,c2Zy
U at Q N oQ
T`
0 600
W3 co ir
LIT
in
Z Co
uA
(CE32fftS`d3Y1) �L6'6i+t M .�.�'�
� ��) M N
5
r�
'o
�o Y
------------
�= U
O
r7
F
G -
J
R.O.W. Permit Attachment of for
R.O.W. Permit# issued , 200_ Atlantic Beach,�F,,L 32233
Owner's Name: ���GuL}/Li 8� A ery--
Property Address: ' 7 4+v% 5r-
�7Z-
Subdivision:
Lot#/Block#:
R.E. #:
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
, 200_, 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 pennission 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: 51 ,ove Lay14oet DhyeT
` V�111A ppTlb 6-s-4' Ste. Dr'L�ui�aillQ'
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 snail, return receipt requested, to the following address:
?� �fh �5i a-kjr T
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 snake 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 1 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 inure 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 andiGNED thisday of /t/1�'} �;�J , 20(�
Il l
By:
Pr`o 66 Owher
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL , ,J
On this 0P,(�
— day of IVAt� 244personally appeared before me, a Notary
Public in and for said County and State, the property owner of
X , 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 samdifreel and v"y "
es and purposes therein mentioned.
JOHN R CARSON
MYCOMMISSION#FF 027076
EXPIRES:June 13,2017
Notary Public in for said Counot Bonded Thru Budget NOWY Services
EOF F�
CITY OF ATLANTIC BEACH,FLORIDA, a
municipal corporation:
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
City of Atlantic Beach APPLICATION NUMBER
(To be assigned by the Building Department.)
Building Department
r ` 800 Seminole Road
Atlantic Beach, Florida 32233-5445 /
Phone(904)247-5826 • Fax(904)247-5845 Date routed:
yJ13��? E-mail: building-dept@coab.us
City web-site: http://vmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
3 Department review required Yes No
J
Property Addres Building
Planning &Zoning
Applicant: I �- Tree inistrator
G ublic Work
Project: r�� is Utilities
Pu is a ety
Fire Services
Review fee $ Dept Signatur
--— Review or Receipt Date
Other Agency Review or Permit Required of Permit Verified B
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 Department First Review: �Approved.
Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE MIN. Second Review: ❑Approved as revised. ❑Denied.
L ORKS Comments:
UBLI TIL
PUB IC SAF Y
Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic BeachAPPLICATION NUMBER
(To be assigned by the Building Department.)
Building Department
800 Seminole Road AP
JAtlantic Beach, Florida 32233-5445
J x Phone(904)247-5826 • Fax(904 5845 ZOfQ Date routed:
twill ' E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
3 JFFirW7
ent review re uired Yes No
Property Addres
d Zoning
Applicant: inistrator
ri rk
Project: ities
ety
ces
Review fee $
Dept Signature r'4�
Review or ReceiptDate
Other Agency Review or Permit Required of Permit Verified B
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 Department First Review: ❑ApP
roved. *enied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: Date:
TREE ADMIN. Second Review: Pproved as revised. []Denied.
PUBLIC WORKS Comments: c ��rlV4 C-%tic..kQI—L
PUBLIC UTILITIES /�I .w4- y
(p Date:
Reviewed by:
PUBLIC SAFETY
FIRE SERVICES
Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by:
Date:
Revised 05/14/09