850 SEMINOLE RD ATT CABLE CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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RIGHT OF WAY PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROW-1 134
Job Type: RIGHT-OF-WAY PERMIT
Description: BURIED FIBER OPTIC SEM RD & PLAZA
Estimated Value:
Issue Date: 5/20/2015
Expiration Date: 11/16/2015
PROPERTY ADDRESS:
Address: 850 SEMINOLE RD
RE Number: 170389-0000
PROPERTY OWNER:
Name: CITY OF ATLANTIC BEACH
Address: 800 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: AT&T
Address:
Phone: - -
PERMIT INFORMATION: PUBLIC WORKS: UTILITY DEPT.:
Full right-of-way restoration, including sod, is required.
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.
FEES:
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
800 Seminole Road 904-247-5800
-5445 -247-5845
Atlantic Beach,Florida 32233 Fax 904
Date 04/20/2015 PERMIT#
Job Address—Between 850 SEMINOLE RD & PLAZA ST ISSUED BY THE CITY
Permitee: AT&T—JOB 53E68241N Telephone#Wk904-727-1552 EMAIL: SM948N(a)ATT.COM
Permittee Address� 735 Mill Creek Rd JACKSONVILLE, FIL 32211 ATTN.- SERGIO MARTINEZ
Requesting Permission to Construct: JOB#53E68241N PROPOSED TO PLACE 305'FT OF BURIED FIBER OPTIC
CABLE AT 30" MIN DEPTH. PLACEMENT WILL BORE UNDER EXISTING TREES AND UNDER ROADWAY PLACING
2" CONDUITS AS INDICATED ON DRAWINGS.
USE CASE 1 MOT
Locatiom (Reference to Cross-Street) SEMINOLE RD AND PLAZA ST
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:
TECO Yes (X) No Date: 04/20/15
Ferrell Gas Yes (X) No Date. 04/20/15
Comcast Yes(X) No Date. 04/20/15
Z 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 JEFF FENLON (Contractor's Project Superintendent) located at
11711-1 PHILLIPS HV\1Y, JACKSONVILLE, FL 32256_Telephone#-. 904-268-0361
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
7. This permittee shall commence actual construction in good faith with 60 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
Signed. ate:-
Before me this -day of_-_in the County of Duval, Jonathan Maurer
State Of Florida,has personally appeared
Notary Public at Large, State of Florida,County of Duval.
My commission expire&
Personally Known: or
Produced Identification:
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City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Q Atlantic Beach, Florida 32233-5445 910 L'i—Dy
Phone(904)247-5826 - Fax(904)247-5845 ate routed: 3__
-dept@coab.us
E-mail: building
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: '9570 SEA4114ILrz- P-0 4 A42-A 5f Department review required Yes No
Building
Applicant: T- Planning &Zoning
I ree Administrator
Project: J D*F �_3 E0 21� W �A-r -6 Public Works
15U
Public a ffety
Fire Services
Review fee Dept Signature 5��
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: 124proved. ElDenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING ed by: Date: t
Review Da
TREE ADMIN. Second Review: FlApproved as revised. OlDenied.
PUBLIC WORKS Comments:
UBLIC UTILITIE
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. F]Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
Showman, Lisa
From: Walker, Jennifer
Sent: Wednesday, May 13, 2015 3:07 PM
To: Showman, Lisa PLAZA ST
Subject: FW: AT&T permit application for 53E68241 N SEMINOLE RD &
Attachments: 53E68241 N APPL.pdf; 53E68241 N DWGS.pdf
Lisa,
I have given this one the routing#15-ROW-1134. It was missed from 4/20/15, sorry. I can't get used to them emailing
permits instead of bringing in paper!
Tx,
Jenny Walker
Administrative Assistant
Building Department
City of Atlantic Beach
904-247-5826 C_�
From: MARTINEZ, SERGIO [maiIto:sm948n(cbatt.com]
Sent: Monday, April 20, 2015 3:11 PIVI
To: Graham, Shirley
Cc: Walker, Jennifer; PERRY, STEPHEN B
Subject: AT&T permit application for 53E68241N SEMINOLE RD & PLAZA ST
Good afternoon,
Please find attached AT&T permit application and drawings for 53E68241N SEMINOLE RD & PLAZA ST. Please let us
know if anything else is required.
Thank you,
Sergio L. Martinez — Engineer/ NFL Permit Coordinator
AT&T Engineering Contractor
National Services, INC.
735 Mill Creek Rd
Jacksonville, FL 32211
E-mail: sm948nkatt.com
slmart82rW,gm,ai1.com
Office: 904-727-1552
Mobile: 305-244-8910