1500 W Park Ter2014 driveway CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
DRIVEWAY PERMIT
MUS I CAtt BY 41-1-1 F-0--R -14-EX-1 DAY!N8Pr!eTtoN. 247 58t4
JOB INFORMATION:
Job ID: 14-00000624
Job Type: RIGHT-OF-WAY PERMIT
Description: SALT ROCK DRIVEWAY
Estimated Value:
Issue Date: 11/4/2014
Expiration Date: 5/3/2015
PROPERTY ADDRESS:
Address: 1500 W PARK TER
RE Number: 171937-0010
PROPERTY OWNER:
Name: OSSI DEVELOPMENT INC
Address: 1112 3RD ST SUITE 4
GENERAL CONTRACTOR INFORMATION:
Name: OSSI CONTRACTING LLC
Address: 13349 STONE POND DR JACK OSSI JR
Phone:
PERMIT INFORMATION: PUBLIC WORKS: UTILITY DEPT.:
per r carper
FEES:
PERMIT FEES $35.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
ENG REV BLDG MOD OR ROW $50.00
Total Payments: $89.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH n
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND
800 Seminole Road L! VA-�47
A)antic Beach,Florida 32233-5445 Fax 904-24711�
Date Ll PERMIT# 11B V--
ISSUED BY THE CITY_
'0"
Job Address So C> I ft \Nt bt
Permitee: ;I JY/5�'Telephone# qoq - 6
Permittee Address: 2- S(-J '-3226
Requesting Permission to Construct:
Location: (Reference to Cross-Street) 16LP j�f A71
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/M unici pal ities:
Jacksonville Electric Authority Yes No Date:
Bell South Telephone Company Yes No Date.-
Ferrell Gas Yes N 0 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 154erida, Department of Transportation Standards and be
performed under the supervision of -I ki- 0-S 41 - (Contrpictor's Project
Superintendent) located at 4.b. , I 11 -4, -�:r.;-tt P-e�-I I lah 4 (34�41 Telephone#:
4. All materials and equipment shall be subject to inspectidn'bpthe birector 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 application.
7. This permittee shall commence actual construction in good faith with -S 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 J
Signed: Date:
Before me this day of )n I Jwy' in the County of Duval,
is
0
Florid has p
State Of 4 ersonally app J,4 c k Al--Y)5,S BOBBIE rHOMPSON
u Ic L
Notary Public Large,State of Florida,County of Duval.
My commission expires: W COMMISSION #FE 839841
Personally Known:
or EXPIRES:October 1,�0 16
Produced Identification: a -
a
R.O.W. Permit Attachment of for
R.O.W. Permit# issued 200 Atlantic Beach,FL 32233
Owner's Name: I I
Property Address: b 12AQ (L Tie-a A-re W
Subdivision: %k)A–
Lot#/Block 3
R.E. #:
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
1h+:�;( 20t–y, by Atlantic Beach, Florida, a municipal corporation organized—and existing
under de laws of the State of Florida, hereinafter referred to as "CITY" and. %),s
of Atlantic Beach, Florida,hereinafter referred to as"USER".
WITNESSETH:
That the CITY does hereby grant the USER permission 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 pennit numbers noted above (copies attached).
This work is generally described as: � �Zo Vk 0 ,�_ L)n1jew- t�.
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 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 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 insure 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 and NED this day of Af 0+� 2044�
By:
PropeK,Owner
(to signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this — day of 200, personally 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)
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:
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
R.O.W.Permit Attachment of- for
R.O.W.Permit# issued 200 Atlantic L 3 233
Beach,F:4
Owner's Name:
Property Address: 1 s--0 o 1,,e Wed-
Subdivision:
Lot#/Block#:
R.E. #:
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
20f Y
, by Atlantic Beach, Florida, a municipal corporation organized and exist*
under de la s of the State of Florida, hereinafter referred to as"CITY"and o4sb:
of Atlantic Beach,Florida,hereinafter referred to as"USER".
WITNESSETH:
That the CITY does hereby grant the USER permission 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: 4/� 0 aivtw
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 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 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 insure 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 and NED this day of Af 204�/
By: 12J,
Prope)�Owner
(to/signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this day of 20V4, personally appeared before me, a Notary
Public in and for said County an State, , the property owner of
Atlantic Beach, Florida, known to me to be the person(s)
r d in and who executed the foregoing instrument; who acknowledged to me that he or she
'be'
ecuted t. �ame free ntarily and for the uses and purposes therein mentioned.
NotaiyTublic in r said Cklmloy and State
ov Notary Public State of Florida
CITY OF ATLA IC BE FLORIDA, IP 1% Shirley L Graham
. IV My Commission FF 086990
municipal corporation: �ar Expires 02114/2010
%0%0%^00S
Ap
Ricky L. Carper,.Jrublic Works/irec/tor
For Permits where city sidewalk is impacted,
City Manager approval required:
Jim Hanson, City Wnager
Page 2 of 2
PUBLIC WORKS PLAN REVIEW COMMENTS
L
Date: Initials: PN M(0
Project Name/Address: Application Permit#:
Check Box TCh�ec
Application Tracking Comments to Add Box to
�omment "Print"
IMPS Provide table of impervious surface calculations for entire lot (existing and post 0
construction). A)
ESCP Provide erosion and sedviment control plans with installation details and maintenance 0
schedule.
DPLN
Provide drainage plans showing site topography(flow arrows, etc.) 13 0
CSMP Provide construction site management plan, including Right-of-Way Permit if using 0 0
right-of-way for construction parking.
TSUR
Provide a pre-construction topographic survey prepared by a Florida Licensed Professional 0 0
Land Surveyor, showing 1'contours.
LDCS Section 24-66(b) of the Land Development Regulations requires on-site storage for
increased run-off if adding 400 SF or more impervious sufface. Provide Delta volume 0 0
calculations and on-site retention required per Section 24-66(b). (See attached information
sheet.)
PCTS If on-site storage is required, a post construction topographic survey documenting proper 0 0
construction will be required.
RWPM A Right-of-Way Permit must be obtained for use 0 0
�RE:PM: A Revocable Encroachment Permit must be obtained. 0 0
PLWP] Pool—Wellpoint (if used) must discharge into vegetated area 10' minimum from street or 0 0
drainage feature (swale, structure or lagoon).
DAPR All concrete driveway aprons must be 5"thick,4000 psi, with fibermesh from edge of
pavement to the property line. Reinforcing rods or mesh are not allowed in the right-of- 0 0
way. (Commercial driveways—6" thick).
URCT Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be
overlaid 10 feet in each direction from the center of the cut. Repair must be shown on the 0 0
plans.
RWRS Full right-of-way restoration, including sod, is required. 0 0
ROFF 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 11 0
Management)
ECIN Full erosion control measures must be installed and approved prior to beginning any earth
disturbing activities. Contact Public Works(247-5834)for Erosion and Sediment Control 0
Inspection prior to start of construction. +
MEET Recommend Owner/Contractor meet with Public Works Director to discuss proposed I I
construction. Call 247-5834 to make an appointment. 11 0
Mo-Ve
0
0 0
_D
City of Atlantic Beach ng pai
'CEIVED APPLICATION NUMBER
Building Department (To be assignFdpy the �uilding partment.)
V 800 Seminole Road MAY08 2014
Atlantic Beach, Florida 32233_5445
5
Phone(904)247-5826 - Fax(59foxi
f31845
[1�r.
07
K) E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us r -
APPLICATION REVIEW AND TRACKING FORM
Property Address: Atg Department review required Yes No
Building
Applicant: VE/d'0' Planning &Zoning
Tree Administrator
Project: al 7' �_ru`blic Wo—r—ks" I�
<--ruDIR5 U���
ME Mc7a-re�y
Fire Services
Review fee $ Dept Signature C
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: EXApproved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: 401A� Date:
TREE ADMIN. Second Review: EjApproved as revised. F-]Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. ElDenied.
Comments:
Reviewed by: Date:
Revised 05/14109
V- City of Atlantic Beach
FR APPLICATION NUMBER
Building Department E (To be assigned b th Building Department.)
y
800 Seminole Road APR 2 2 2014
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)24 -5845
Date routed: C;�)
E-mail: building-dept@coab.us By,
City web-site: http://vvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review required Yes No
Building
Applican Planning &Zoning
Tree Administrator
Project: I T C_Fu�blic WorkD
PubFi—cUtilities
Public Safety
Fire Services
Review fee Dept Signature AQ1_ VWTJ
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: [:]Approved. ODenied.
(Circle one.) Comments:
BUILDING IL9,
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: 41pproved as revised. FIDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:4A7�� D a t e. L)
FIRE SERVICES Third Review: nApproved as revised. ElDenied
Comments:
Reviewed by: Date:
Revised 05/14/09
_� vj Ir- City of Atlantic Beach RE APPLICATION NUMBER
CFIVFD
Building Department 7f-- g epartment
i (To be assignecipy the quildin
800 Seminole Road 118 20 i Iq .
1m; r) i
X Atlantic Beach, Florida 32233-5445 MAY 0 8 2014
Phone (904)247-5826 - Fax (904)24-5845
E-mail: building-dept@coab.us LBy- Date routed:
Cityweb-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /
Department review required Yes No
Building
Applicant: ]!v VE .P�6 1 7r'- Planning &Zoning
Tree Administrator
Project: a/7- Vl 6 �"ru�l—lcwo—rks---_)
<--VUD11C U[11111�
Public batety
Fire Services
Review fee 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: VApproved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by� Date:
TREE ADMIN. Second Review: F]Approved as revised. FIDenied.
4 V WoRKs Comments:
'0
PU LIC UTILI
— —1
PUBLIC ASAFET Reviewed lby� Date:
FIRE SERVICES Third Review: E]Approved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09