168 Magnolia St 2014 ROW CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
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Application Number . . . . . 14-00000897 Date 6/11/14
Property Address . . . . . . 168 MAGNOLIA ST
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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SULLIVAN, KATHY G OWNER
2216 OCEANFOREST DR W
ATLANTIC BEACH FL 32233
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Permit . . . . . . DRIVEWAY PERMIT
Additional desc - - . 00
Permit Fee . . . . 35 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 12/08/14 ---------------
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Special Notes and Comments
Avoid damage to underground water/sewer utilities . Verify
vertical and horizontal location of utilities . Hand dig if
necessary. If field coordination is needed, call 247-S834 .
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.
Street must be swept clean daily. All work on private
property -- no pavers in City right-of-way.
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 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 29 . 00 29 . 00 . 00 . 00
Grand Total 64 . 00 64 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
800 Seminole Road 904-247-6Q8, SJU11
Atlantic Beach,Florida 32233-5445 Fax 904-247-S845
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PLEASE SUBMkT
,OCOMPLETE SETS OF PLANS WITH APPLICATION.
Date 6IS114
9 PERMIT#
Job Addres if 14 S7- ISSUED BY THE CITY
Permitee: �'A;17W V Telephone
Permittee Address:
Requesting Permission to Construct: rers To Tit V f Z __P r Vi Wfiy
Location: (Reference to Cross-Street) 116
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 ( ) 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 Depprtment of Transportation Standards and be
performed under the supervision of (Contractor's Project
Superintendent) located'at 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.
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 aPPI!Gation.
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.
OWNER
Signed:&fftZ4. A ��Date:
Before'me tN in 2/�)n�ty of Duval,
State Of Florid-a-,'175s;person 11 d lkklko"�I I I I I I I I I I%, I,,, �
,��ffry_,ktb1rE_a�Large State ounty of Duval. Ly P
yc m Xpi IMS
0 otRTeyAL@Gqraham
or iss�� r 11[.���ced I on,' we of Florida
My COMMiS31on FF 086990
ExPirls 02t14/2018
R.O.W. Permit Attachment of for
R.O.W.Permit# issued 200 Atlwitic Beach, FL 32233
Owner's Name: SIU111,
Property Address: Aox A VIA_ Jr
4f 6
Subdivision:
Lot#/Block#:
R.E.
REVOCABLE ENCROACHMENT PERTvHT
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 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 nurribers noted above (copies attached).
This wor enerally described as: ;)-r a V OJA 0-r�g 7_,f 7-D
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 and the burden is upon USER to keep the CITY infornied 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.
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 pen-nit 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 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 hereft-i under the terms of this
permit and that all of said liabilities are hereby assumed by the USER.
DATED and SIGNED this day of 200
By:z
Prope]R�wner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this day of 2014personally 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)
desc�� in and who executed the foregoing instrument; who acknowledged to me that he or she
cuted s me eely nd aril nd for the uses and purposes therein mentioned.
N7a_�Fublic`in for 6id Co nd State 40 P Notary PubUc State of Florida
fo shidey L GrahaM
my commission FF 086990
CITY OF ATLANTIC BEACH, FLORIDA,a OF F_Xpires o2l14MM
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
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City of Atlantic Beach -�CFEIVEI r-: APPLICATION NUMBER
'14"V o
(To be assigned b he Building Department.
Building Department
800 Seminole Road L JUN 0 4 2014
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247
Date routed:
E-mail: building-dept@coab.us
City web-site: http://vmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review required Yes No
AV"— Building
)e _ II&J_6CAV.I --
Applicant: 1?2 fz Planning &Zoning
Tree Administrator
Project: 2)7-i VI/L) oy ublic Work§
T6- Public Safety
Fire Services
L *-'
Review fee $ T5'- 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 Department First Review: �rApproved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by:_ Date: 6's'-w
TREE ADMIN. Second Review: FlApproved as revised. FIDenied.
PUBLIC WORKS Comments:
6�;�
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: MApproved as revised. [-]Denied.
Comments:
Reviewed by: Date:
Revised 05114109
fj 2AV'C'P< -
City of Atlantic Beach APPLICATION NUMBER
CEIVF by h Bjilding Department.)
(To be assigned e i
Building Department
eminole Road
800S /y_ f
Atlantic Beach, Florida 32233-5445 JUN 0 4 2014
Phone(904)247-5826 - Fax(904)24r-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://viww.coab.us Lf�y_:_� =7= -
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review required Yes No
Building
Applicant: Planning &Zoning
Tree Administrator
Project: ec, ublic Work
u i tilitie
_11'�Noftrm& 7-6 Public Safety
Fire Services
Review fee $ Dept Signature k
vt
Other Agency Review or Permit Required Review or Receipt Date '�p �e–�
— of Permit Verified By Ard LooLi
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. E]Denied.
Op
Comments:
(Circle one.)
BUILDING
PLANNING &ZONING Reviewed by-.— Date:_�_' ?�(fl
TREE ADMIN. Second Review: RApproved as revised. RDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: RApproved as revised. ElDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09