1175 Atlantic Blvd 2014 rowCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
�-15-'--� RIGHT OF WAY PERMIT
Ml IST CALL BY 412M FOR NEXT DAY INSPECTrntu• 7A7-SRl a
JOB INFORMATION:
Job ID: 14 -ROW -128
Job Type: RIGHT-OF-WAY PERMIT
Description: H20/SEWER CONNECT, PLACE PIPE FOR DWAY, OUT FALL
Estimated Value:
Issue Date: 10/10/2014
Expiration Date: 4/8/2015
PROPERTY ADDRESS:
Address: 1175 ATLANTIC BLVD
RE Number: 170709-0000
PROPERTY OWNER:
Name: ROBBINS NEST FARMS LLC,
Address: 1560 SELVA MARINA DR
PERMIT INFORMATION: UTILITY DEPT.:
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-
5834.
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.
FEES:
Fence/ROW $35.00
ENG REV BLDG MOD OR ROW $25.00
UTIL REV MODIF OR ROW $25.00
Total Payments: $85.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Be ii
Building Departme.,t Cid i (
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone (904) 247-5826 - =ax (904) 247-5845"
City web -site: http://www.,;oab.us
APPLICATION NUMBER
(To be assigned by the Buildin Department.)
Date routed:
APPLICATION ' REVIEW AND TRACKING FORM
Property Address:' 1 -.. I Q L EWA De artme,
�� Building
Applicant: L �� �/�% Planning F
Project: `w S�V%�i �" is W
P� aIGG ,�44 Public U
y� Pu Ic
'O� It, S I `"� Fire Sc
Review fee $ Dept Signature _
CONTRACTOR EMAIL ADDRESS
CONTRACTOR CONTQ " #
Reviewing Department
(Circle one.)
BUILDING
PLANNING & ZONING
TREE ADMIN
PU WORKS
AKYTILITI S
, BL4e-SXFETY
FIRE SERVICES
REVISED 09252014
APPLICATION STATUS
re uired Yes No
/�3�
`11%
Qy-/"c "�
First Review Approved. ❑Denied.
Comments.
Reviewed by: Date: l y
Second Revi w: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date
Third Revi FlApproved as revised. [—]Denied.
Comments
Reviewed by:
Date:
Walker, Jennifer
From:
Kaluzniak, Donna
Sent:
Friday, October 10, 2014 9:05 AM
To:
Walker, Jennifer; Walker, Chris
Subject:
RE: 14 -ROW -128
Jenny, that is correct, unless they decide they want a larger water meter. They have not mentioned anything about that,
so will assume current meter is acceptable. We can always upgrade later if they need to. (they are also installing a well,
so will probably have plenty of water with the City & well) — thanks, Donna
From: Walker, Jennifer
Sent: Friday, October 10, 2014 9:01 AM
To: Kaluzniak, Donna; Walker, Chris
Subject: 14 -ROW -128
Donna,
Thank you for approving the Urban Farms, 1175 Atlantic Blvd ROW permit so quickly. I just wanted to confirm that
because there was a business on site previously that there won't be any water or sewer fees for this permit, before I call
them to pick up the permit.
Thanks and Happy Friday!
JMvt,U WaLleer
Administrative Assistant
Building Department
City of Atlantic Beach
904-247-5826
1 City of Atlantic Bea i r',�
Building Departmer, ,.
;01'I 800 Seminole Road
J �r Atlantic Beach, Florida 3i. 33-5445
Phone (904) 247-5826 • ax (904) 247-5845 l Z014
City web -site: http://www.,;oab.us
APPLICATION NUMBER
(To be assigned by the�� Department.)
�I 2z
Date routed: ' V 1 —2/
APPLICATION REVIEW AND TRACKING FORM
Property Address: 5 t 1 a &VA Department review
� � � Building
Applicant: B �/j�Win 4- Wkc C*pet Planning & Zoning
J
140/S� �� W istrator
Project:Public
PlAct '( d044 Public Utiliti
� es
f , Public Safety
Fire Services
Review fee $ b Dept Signature G�-
CONTRACTOR EMAIL ADDRESS
CONTRACTOR CONTACT #
APPLICATION STATUS
Reviewing Department First Reviev Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING
Reviewed by: -
TREE ADMIN. Second Rev. ,v: []Approved as revised. ❑Denied.
PUBLIC WORKS I Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
FIRE SERVICES
REVISED 09252014
Reviewed by:
Third Revie []Approved as revised. [—]Denied.
Comments:
Reviewed by:
Date:
Date:
Yes
CITY OF ATLANTIC BEACE
CONSTRUCTION PERMIT WITH[
800 Seminole Road
�� '' • A0• B h FI 'd 32233 54 5
V�„ lh �
an, eac , on a - 4
PLEASE SUBMIyf COMPLETE SETS OF PLANS WITH APPL )
Date ' '
Job Address 11-75 A+—faahc— B(vj
Permitee:�7)ln/VI.
Permittee Address:
esting Permission to
Location: (Reference to Cross -Street)
PERMIT
ISSUED P.Y THE CITY
Telephone# ��[ � 0Q — 70 9
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 ( ) Ncj ( ) 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 rr� �{zj (1M,,CS (C ntra tor's Project
Superintendent) located at Telephone 04 4-5 -,5l ((p
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 anv increase in impervious rea 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 tie holder, and the Holder will, at all
times, assume all risk of and indemnify, defend, and save harmless thy= City of Atlantic Beach from and
against any and all loss, damage, and cost of expenses arising in any rr;nner 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 T
�. pow ION
Notary Public Stare of Florida
gthe
� . • Kimberly A Billingsley
Signed: Date: `1 My commission EE 194120
Before me th' +nday of o or w Expires 04/30/2016
State Of Florida, has personally appeared e4' e -
Notary Public at Large, State of Florida County of Duva
My commission expires: C LA 3U j-Z01(.o Persona ly Known: ✓
Produced Identification:
R.O.W. Permit Attachment _ of
R.O.W. Permit # issue , 200
Owner's Name:
Property Address:
Subdivision:
Lot # / Block #:
R.E. #:
for
Atlantic Beach, FL 32233
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 F r=da, hereinafter referred to as "CITY" and
of Atlantic Beach, Florida, here :er referred to as "USER".
WITNESSETH:
That the CITY does hereby --mt the USER permission on a revocable basis as described herein the
right to enter upe rrnnerty of the City of Atlantic Beach for the purpose as described in the City of
Atlantic Beach R -- ;t numbers noted above (copies attached).
This work is
Any facilit
remains subje,
USER shall
The depc
cancellation
A961yms
c4S' 70 74�
.lied in the exercise of the privilege granted
> notice by CITY to the USER, said notice to
-ipt requested, to the following address:
nited States mail shall constitute the notice of
CY informed of USER's proper address.
The USS y repairs to any facility erected or maintained in
the exercise of tuc Y... _ _ 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 mak.ingrany- changes from the approved p=_::, its and/or method, must obtain
written approval from the City= of Atlantic Beach, Public Works D :Iartment, for said change. The
USER shall, at the discretion of the CITY, be requested to submit as -1-,., i it 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 ai : t the applicable State and CITY
laws and/or specifications, to knelude 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 , 200 .
LE
Property Owner
(to be signed in presence he Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this day of 200_, personal'.. appeared before me, a Notary
Public in and for said County and State, the property owner of
, Atlantic Beach, Florida, k;'« Avn 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 same freely and voluntarily and for the uses and purposes therein mentioned.
Notary Public in for said County and State
CITY OF ATLANTIC BEACH, FLORIDA, a
municipal corporation:
Approved:
Doug Layton, Public Works Director.
For Permits where city sidewalk is impacted,
City Manager approval required: ,
Nelson Van Liere, City Manager
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