282 pine St 2014 row CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
FL 32233
-fj ATLANTIC BEACH,
INSPECTION PHONE LINE 247-5814
RIGHT OF WAY PERMIT
IS1 CA' NEXI DAX INSPECTION' 2A7-r%R'
JOB INFORMATION:
Job ID: 14-ROW-101
Job Type: RIGHT-OF-WAY PERMIT
Description: concrete to concrete driveway
Estimated Value:
Issue Date: 10/3/2014
Expiration Date: 4/1/2015
PROPERTY ADDRESS:
Address: 282 PINE ST
RE Number: 170551-0000
PROPERTY OWNER:
Name: CAMPBELL, MARIA COLLEEN
Address: 282 PINE ST
PERMIT INFORMATION: PUBLIC WORKS:
FEES:
Fence/ROW $35.00
Total Payments: $35.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY �%ND EASEMENTS
Boo Se ninole Road 904-247-5800
Atlantic Beach,Florida 32233-5445 Fax 904-247-5845
PLEASE S UBMkT�t*COMPLETE SETS OF PLANS WITH APPLICATION.
1 -100 bj4V9
Date
nPERMI
I M"
ISSUED THE CITY
SUED,
Job Address r -
Permitee: Al-la L�4 J,14 02 be Telephone#
-T
Permittee Address: %A�- 5�re.e-f Ift'i t
Requesting Per ission o Construct:
Location: (Reference toqross-Street)
1. Applicant declares that prior to filing this application he has ascertain.t.! 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( ) Date:
Ferrell Gas Yes ( ) Date:
Comcast Yes ( ) Date:
2. Whenever necessary for the construction, repair, improvement, maintep.a.nce, 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 (Contractor's Project
Superintendent) located at Telephone#:
4. Ail materials and equipment shall be subject to inspection by the Director n!.'Public.Works or his designee.
5. All city property shall be restored to its original condition as fair as practic-0, 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 ,)t a recent survey shall be made a
part of this permit. CaIGUlations showing any increase in impervious, faa 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 I-E '-,v the permit with the Director of
Public Works to make sure no changes have occurred in the area that wo, affect the permitted construction.
& It is understood and agreed that the rights and privileges herein set out granted only to the extent of the
City's right, title and interest in the land to be entered upon and used by iolder, and the Holder will, at all
times, assume all risk of and indemnify, defend, and save harmless t1--. City of Atlantic Beach from and
against any and all loss, damage, and cost of expenses arising in any f i-�-,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.
40 of,,
Notary Public State of Florida
OWNER Julia L Johns
My Commission FF 073462
Expires 11/2612017
Signed: Date: of
Before me this cpk!V�tj YiN I
,n '____�day of �eQM�k in the CoSnty of Duval,
State Of Florida,has personally appeared_ /,-I L4 I k a- -,VN V",
Notary Public at Large,State of Florida,Countv of Duval.
My commission expires: fAlo - L-7 Persona. Known:
Produced Identification:
R.O.W. Permit Attachment—of for
R.O.W. Permit#—issue 200_ Atlantic Beach, FL 32233
Owner's Name:
Property Address:
Subdivision:
Lot#/Block#:
R.E. #:
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
1 2009 by Atlantic Beach, Florida, a municipal corporation organized and existing
under the laws of the State of F1 --ida, hereinafter referred to as "CITY" and
of Atlantic Beach, Florida,here referred to as "USER".
WITNESSETH:
That the CITY does hereby' M. t the USER permission on a revocable basis as described herein the
right to enter upon the property ofthe City of Atlantic Beach for the purpose as described in the City of
Atlantic Beach Right-of-Way/Easimentpermit numbers noted above(copies attached).
This work is generally described as:
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 OITY 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 informed 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 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,I of 2
The USER, prior to makingir,-any.:changes from the approved pt::ias and/or method, must obtain
written approval from the Clity,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 i,t drawings showing the change
within thirty(30) days after tlz�-Jay. of completion.
This permit shall inure tc, 'die benefit of, and be binding upor,. the USER and their respective
successors and assigns.
USER shall meet the terms and conditions of this permit and to ai iif the applicable State and CITY
laws and/or specifications, to include utilities locate requirements and use limitations/requirements of
public rights-of-way and otht:r: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
BY:
-Fr-o-perty Owner
(to be signed in presence le Notary)
STATE OF FLORIDA
COUNTY OF PUVAL 14
On this (9:2�day of 2 solaai-i appeared before me, a Notary
Public in and for §,ald Count and State, C I a gin , the property owner of
QL Atlantic Beach, Florida, to me to be the person(s)
V e that he or she
described in and who executed.-the foregoing instrument; who acknowledged to m
uted the same freelly and volu. tarily and for the uses and purposes therein mentioned.
uted the same ee' anc"O'u 'arily an'
No ublic in for said unty and State 3W ftj�. Notary Public State of Florida
a Julia L Jonns
Y .
L My Commission FF 073462
CITY OF ATLANTIC BEACH, FLORIDA, a Expires 11126/2017
municipal corporation:
Approved:
Doug Layton, Public Works Direct&
For Permits where city sidewaik is impacted,
City Manager approval required: -
Nelson iere, City Manager
Page 2 of 2
MAP SHOWING BOUNDARY SURVEY OF.-
LOT 516, SALTAIR SECTION NO. 3. AS RECORDED IN PLAT BOOK 10.
PAGE 16 OF THE CURRENT PUBIJC'RECORDS OF DUVAL COUNTY, FLORIDA
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City of Atlantic Be;-� APPLICATION NUMB
PPL'C
(To be assigned by the Building Department.)
Building Departmei ;ed /40
800 Seminole Road �EP o
Atlantic Beach, Florida 32- 3-5445
Phone(904)247-5826 - -ix(904)247-5845 4
ro
b-site: http://vm ab.us EDate utied.
41 r I City we
APPLICATION REVIEW AND TRACKING FORM
Department review required Yes No
Property Address: '229 R-0
�/ Building
LAf W-)7 Planning &Zoning
Applicant: Tree Administrator
Project:
U
116 OAY Public Safety
re Services
;F i!F7
Review fee Dept Signature
CONTRACTOR EMAIL I DRESS .
CONTRACTOR CONTAC #
APPLICATION STATUS
It First Review: NApproved. $erni(�d.
Reviewing Departmen
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: =Dat6:
TREE ADMIN. s vis
Second Rev;;-w: nApproved a! revised. Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Revie%% FlApproved as revised. FIDenied.
Comments:
Reviewed by: Date:
REVISED 09252014
i APPLICATION NUMBER
City of Atlantic Beach fo be assigned by the Building Department
Building Department V
800 Seminole Road Sep 3 0
Atlantic Beach, Florida 32233-5445
Phone,(904)247-5826 - Fax(904)247-5845 ?014 Date routed:
Pf city web-site: http://wv4w.coab.us
APPLICATION REVIEW AND TRACI,(.ING FORM
Depart�'.- nt review required Yes No
Property Address: Building_
Plannint Zoning
L.*f* Tree Ac'. istrator
Applicant: Public W'.'r
e4z ne— U
Project Public Safety
i/t a-MY Fire Sc. vices
Review fee Dept Signature
CONTRACTOR EMAIL I 'DRESS
CONTRACTOR CONTAC" #
APPLICATION STATUS
Reviewing Department First Review: pproved. E]Denie,
(Circle one.) Comments:
BUILDING Date:
PLANNING &ZONING Reviewed b
TREE ADMIN. Second Reviow: []Approved as revised. nDenied.
PUB I Comments,
P L UTI TI Reviewed by:__�-— Date:
LIC SAF TY ---------
FIRE SERVICES Third RevieA EJApproved as revised. []Denie,
Comments:
Date:
Reviewed by:---
REVISED 09252014