1858 Selva Grande Drive PAVERS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
DRIVEWAY PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 14-00000670
Job Type: RIGHT-OF-WAY PERMIT
Description: concrete to pavers
Estimated Value:
Issue Date: 4/10/2015
Expiration Date: 10/7/2015
PROPERTY ADDRESS:
Address: 1858 SELVA GRANDE DR
RE Number: 169542-5020
PROPERTY OWNER:
Name: FLEMING, THOMAS
Address:
PERMIT INFORMATION: UTILITY DEPT.: PUBLIC WORKS:
FEES:
ENG REV BLDG MOD OR ROW $50.00
UTIL REV MODIF OR ROW $25.00
PERMIT FEES $35.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $114.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
�C
CITY OF ATLANTIC BEACH AP
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND IVIEN�SL 8 20,1,4
800 Seminole Road
904-247-5800
7- Atlantic Beach,Florida 32233-5445 Fax -75845
PLEASE SUBMITOCOMPLETE SETS OF PLANS WITH APPLICATION.
Date— L/
I / PERMIT#
Job Address ISSUED BY THE CITY
"
Permitee: lqjv,�,�ea Telephone
Permittee Address: 11,6 1J, 120 S- 4—ye-
Requesting Permission to Construct: 14-Gf- ck-,'V_e
Location: (Reference to Cross-Street)
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/Municip7aliti �:
Jacksonville Electric Authority Yes No Date:
Bell South Telephone Compa Yeso /No Date:
Ferrell Gas Yes ( �, �Io Date:
Comcast tILE COPY 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 @11 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 De artment of Transportation Standards and be
per-formed under the supervision of 7,_��I-''A XV %,I/, _(Contractqr's Project
Superintendent) located at ITT9" rf rC�C_ Telephone#: /9"/2 47V-//*-
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 WaV are to be included with this application.
7. This permittee shall commence actual construction in good faith with 7 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.
MARCHAND ANDR:EA TEBBE
OWN E R B
0
My COMMISSION#EE0]49630
'm
EXPIRES December 16,2014
49�-�-/,
Signed: Date: o -4
7t
Before me this ay OF_A_N)r,(_ in the County of duval, Florida Nota rySe"ice.com
State Of Florida, has personally appe�ared k/ I'l ,I V�
Notary Public at Large,State of Florida,Cou t o Duval.,
My commission expires: L)_-�e L4,— I&? - -2,1!k Personally Known:
I Produced Identilication:
R.O.W. Permit Attachment of for
R.O.W. Permit issued 5200 Atlantic Beach,FL 32233
Owner's Name: -7-0m F]eer i'en
Property Address: Ig59 5elvao*all
Subdivision:
Lot#/Block
R.E.
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACIIMENT PERMIT, issued on this day of
209y,'by Atlantic Beach, Florida, a municipal corporation organized and existing
under th9 laws of the State of Florida, hereinafter referred to as "CITT' and -ro,11 rl'-fri AT
of Atlantic Beach,Florida,hereinafter referred to as"USEW'.
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 nurnbers noted above (copies attached).
This work is generally described as: n,�,,A�-oi--oaqe
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 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 (li) which states "Driveways that cross sidewalks: City sidewalks may not be
replaced with other materials, but must be replaced with smooth concrete left natural ii-i color so that it
matches the existing and adjoining sidewalks."
Page 1 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 (3 0) 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 I 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 SIGNED this dayof 20da
By:
Property Owner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this day of 20"personal�y appeared before me, a Notary
.jqpvl -
Public in and for said county and State, the property owner of
FcLin_L__�'
Atlantic Beach, Florida, knovin)to me to be the person(s)
described in and who i6xecuted the foregoing instru I ment; who acknowledged to me that he or she
executed the same freely and voluntarily and for the uses and purposes therein mentioned.
MARCHAND ANDREA TEBBE
No ublic irfor said CoTRy and State
My COMMISSION#EE049630
EXPIRES December 16,2014
CITY OF ATLANTIC BEACH,FLORIDA, a L I Floridallotaryservice.com
municipal corporation:
Approv d:
Ricky L. Ca er,Public orks Director
For Permits where city sidewalk is impacted,
City Manager approval required:
Jim Hanson, City Manager
Page 2 of 2
MAp SH047NG BOUNDARY SURVEY OF
LOT-- BLOCK � AS SHO WN ON MAP OF
17 jz_n,
-Z' THE PUBLIC RECORDS OF DUVAL COUNTy. FLORIDA
AS RECORDED IN PLAT BOOK t9S PAGFSI::��'- a-OF
CER T7FIE0 FOR.-
1111:FjoV ZLWC OATA DENO/[[)HCO
or
4� Cf011NAsACOUmrrsy4wLr-1)v �Nor
ONS11JUlt:A CERTMAITWOF 111C 5"r-
antic Beach
pts-ndne n"0epturtroeft
This approoval"ri wcom.pitance v.4th appficabb
zoning, subdthris m and other local land
devetwment reluu lons,but does not constilds
Oppmvilt,for to is$ame 0,lwrrift� C."tam.
vAth Flo6W&jMnt Code and all other 3131plicabit
local,$tat*wW F�flems permitting requirements
Inlist of the City of Allfinflo
B#:�bs verified bt, turf to the*
Wid"Or$!"
10 of a
011114ing P.,r&/
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NOT VALID UN'--- "ccrn LMT74 EFAL THE UNDERSIGNED. y-—c�n nrU 1-j LINE AS SHOWN
WITHIN FLOOD HAZARD ZONE AS SCALV_FROM FLOOD
THE PROPERTY SHOWN HEREON APPEARS TO UE
INSURANCE RA TE MAP 0CM2 e, FOR THE CITY OF FLORIDA, OA TED
TRI-STATE 1AND SURVEYORS, INC.
8411 BAYMEADOWS WAY SUITE p, IACKSONVILLE, FLORIDA 32256 (904) 7,31-7235
LEGCNO I HEREBY CER77FY THAT THE ABOVE LANDS WERE SUR VE(ED UNDER M Y
0 CONC may RESPONSIBILE SUpERWSIOIV AND DIRECTION, THAT THERE ARE NO
0 IRON CCR, ENCROACHMENTS EXCEPT AS SHOWN AND THAT THE SURVEY SHOWN
(Xt MTN CAP j LS 4144) HEREON MEETS THE MINIMUM TECHNICAL STANDARDS SET FORTH BY
`A�fTJqCf THE FLORIDA BOARD OF LAND SURVEYORS PLIRSUANT TO SECTION
0 SON=(FOUND) 472.027, FLORIDA SrATUTES-
0 oloss cur "I
aF,L OUILONG ACSMi"ON UNE LARRY G. EDDY P.L.S. No. 4144
M'r Wmair I ,_ Z�I
M1W )VGHT-CF-WAY SCALE.
Coy CoWr"AMA
f CrNTv"'E GIS R VWE , rA IF OF ORIDA
All, Aff?CONDIIJOKINC PAD DA TE. Ca-97
No.
City of Atlantic Beach C APPLICATION NUMBER
_1VED1 (To be assigned by the Building Department.)
Building Department
800 Seminole Road 7APR 2 9 2014 L
Atlantic Beach, Florida 32233-5445
- Fax(904)2 BY45
Phone(904)247-5826 1 outed:
LlDat=ero�-.
E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: J� -P de Department review required Yes No
Building
Applicant: 77 f Af Planning &Zoning
Tree Administrator
Project: 00,Mzteg F-F,- 734.4 blic Wor&O
Utiliti��es ...__
Public Safety
Fire Services
Review fee 5-b- 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
APPLICATION STATUS
Reviewing Department First Review: Approved. E:]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by:4e;;�;
TREE ADMIN. Second Review: [-]Approved as revised. nDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: F-JApproved as revised. OlDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach RE EIVED-1 APPLICATION NUMBER
*-FCE'VEI
P
Building Department (To be assigned by the Building Department.)
APR 2 9 2014
800 Seminole Road _5445 L
Atlantic Beach, Florida 32233
Phone(904)247-5826 - Fax(904)2 .5
:_ Date routed:
E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review required Ws
Building,
Applicant: Planni-,.,-t 8., Zoning
Tree Administrator
ublic Wor
Project:
f
!EnrLr—Uti I iti:es
Public Safety
Fire Services
R ew"fee $
evi 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:
PPLICATION STATUS
Approved. [:]Denied.
Reviewing Department First Review:
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Date:
Reviewed by:
T TFRE DMIN
ROED N I N Second Review: nApproved as revised. E]Denie,
M
E
WOR
K Comments:
0141)
1
LITI
Reviewed by:_. Date:
T
T
PU LIC SAFET
FIRE SERVICES Third Review: RApproved as revised. E]Denie
Comments:
Reviewed by: Date:
Revised 05/14/09