1797 MAYPORT RD ROW APP Ir�;yr City of Atlantic Beach
r APPLICATION NUMBER
s� Building Department
s 800 Seminole Road (To be assigned byytnthe,,..B��uilding Depa;qo
IOW
v Atlantic Beach, Florida 32233-5445 �j^ CJ Phone(904)247-5826 • Fax(904)247-5845
WI E-mail: building-dept@coab.us Date routed: �15
City web-site: http://www.coab.us
__
APPLICATION REVIEW AND TRACKING FORM
Property Address: q M a`�,o�►F+ d, Department review required Yes No
Building
Applicant: Planning &Zoning
2C� Tree Administrator
Project: J J 1.�� "CL• ublic Works
�� 'VV �" Qbl l`((,�"�" 13� d Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
Florida Dept. of Environmental Protection of Permit Verified By Date
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
TREE ADMIN. Reviewed by: Date:
Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
ENGINEERING DESIGN
ORACLE PERMIT MAXIMO DATE REL
PROJECT#:8002684 N,O,: FORTHCOMING WO#: 22803513 CONST: 3-11.2015
CIR. TREE TRIMMING
SUB-STA: NEPTUNE N,O.: 565 REQ'D:NONE
CELL
ENGINEER: HGALE N,O.. 219.9714 ZIP CODE: 32233
CUSTOMER/ SVC PHONE
LOCATION: 1797 MAYPORT RD.(X-ST MAYPORT RD.) CENTER: SOUTH N.O.:665.4191
THIS PROJECT PROPOSES TO INSTALL A NEW 35 FOOT CLEARANCE POLE AND 75 LF OF 210 PAP TO FEED A
NEW HABIJAX BUILDING.
STA 01 -CONNECT AT POLE#43 AND RUN 75 LF OF 210 PAP TO STA 02.
STA 02 - INSTALL NEW 35-4 WOOD POLE #40, CONNECT TO NEW PAP AND REFEED TEMP POLE. SET POLE
DEEPER TO AVOID GUYING,
FUTURE UG SECONDARY BY OTHERS.
PLEASE CONTACT ONE CALLAND USE CAUTION WHEN DIGGING.
PLEASE CONTACT THE CITY OF ATLANTIC BEACH AT 904-247-5814 AT LEAST 24 HOURS PRIOR TO STARTING
WORK.
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CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
800 Seminole Road 904-247-5800
91�1i Atlantic Beach,Florida 32233-5445 Fax 904-247-5845
PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION.
Date 03/11/2015 _...... PERMIT a
Job Address 40 Stanley Rd. Atlantic Beach I ISSUED BY THE CITY
Permitee: JEA - Harold Gale Telephone# (904) 665-4191
Permittee Address: 21 West Church St. Jacksonville FI 32202
Requesting Permission to Construct: a 35 foot clearance pole and secondary for a Habijax project
Location: (Reference to Cross-Street) One block east of Mayport rd
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: (" Unit-CHIC
Bell South Telephone Company Yes( ) No Date: f t
Ferrell Gas Yes( ) No Date: f r
Comcast Yes( ) No (v) Date: r.
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 MATT STAFFORD (Contractors Project
Superintendent)located at JEA SOUTHSIDE SERVICE CENTER Telephone#: 665.7940
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 application.
7. This permittee shall commence actual construction in good faith with 45 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
�.(Date: 5
`� Zo 1
Before is P3 ed of in the County of Duval,
State Of lore a,has person y appe red
Notary ubli at Large,Stat of Florida,County of Duval.
My co .rroion expires. Personally Known:
Produced Identification: