Loading...
313 OCEANWALK S DR DRIVEWAY CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 DRIVEWAY PERMIT MUST CALL I3Y4PM FOR NEXT DAYINSPECTION: 247-5814 30B INFORMATION: Job ID: 15-DWAY-1 192 Job Type: DRIVEWAY Description: DRIVEWAY PATIO REPLACEMENT Estimated Value: Issue Date: 5127/2015 Expiration Date; 11123/2015 PROPERTY ADDRESS: Address: 313 S OCEANWALK DR RE Number: 169463-0578 PROPERTYOWNER; Name: PARK, STEPHEN, ' Address: 313 OCEANWALK DR S GENERAL CONTRACTOR INFORMATION: Name: EARTH WORKS DESIGN & Address: 11111 -70 SA SAN JOSE BLVD APT 297 11111-70 SAN JOSE BLVD#297 Phone: - - PERMIT INFORMATION: UTILITY DEPT.: PUBLIC WORKS: Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. A sewer cleanout must be installed at the property line. Cleanout must be covered with an RT1 concrete box with metal lid. Cleanout to be set to grade and visible. 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 Inspection prior to start of construction. All silt must remain on-site during construction. Roll off container company must be on City approved list and container cannot be placed on City Right- of-Way. (Approved:Advanced Disposal, Realco, Republic Services,Shappel's and Waste Pro.) Full right-of-way restoration, including sod,is required. FEES: Fence/ROW $35.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CTrY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. A&L CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Total Payments: $35.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH O"MANCES AND THE FLORIDA BUILDING CODES. City of Atlantic Beach c Building Department AP Ll ATI N NUMBER 800 Seminole Road east n by the Building Department) tiantic each, 1011 a 32233- RAY 0 (To be hone(9 7 2 11 Fax( .. . �015 12, -mail u I ing-do mab,us ItY we -site ht I web LIS Date routed.. APPLICATION REVIEW AND TRACKING F ORM Property Address: 313 Department review required Yes No Applicant" Bu, * Planni Zonin Project: Public Wo I r nus rotor J L! IC I R� 6#1 IF Pu Ic afetv Fire Services Review fee $ 2 r— Dept Signature Zz� Other Agency Review or Permit uired Review Or Receipt Florida Dept.of Environmental pmt 0 Of Permit Verified 8 Date Flonda Dept. Of Transportation n 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: (Circle one.) Comments: Uprl�­ed. oDenied. BUILDING PLANNING&ZONING TREE ADMIN. Revievved by: Second Review: EIAPProved as revised. Date lu OR Comments: UlDenied U U LITIES ef, "I ,51- f PUBLIC SAFET4 Reviewed by: FIRESERVICES Th Comments:: ened. Reviewed by:--------�Date: iSed 071VII0 CITY OF ATLANTIC BFACH MIMI CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS 800�hnola R.M 9�247-5M M&nic liea�,RcxWa 322�5 Fa� 9�247� PLEASE SUBMR(3)COMPLETE SETS OF PLANS WITH APPLICATION. Date. 5� — Job Address 13 6buxi woax b 1. 131 1 Permitee: ve PrK Telephonte# PermlitteeAddrem: 313 ea-At,.^W�,Ix br.'7- RsquestlngParmjssiontoConmuct:-��,,e' Aeve " Location: (nn,�,47or&r�k -Ve, 6�+ 1174 1� Applicant declares that prior to Ming this application he has ascertained ft location of all existing utilities, both aerial and underground and the accurate locations am shown on the sketches. A Letter of Notifiaafion was mailed to the following Utilifies/Municipalifies: Jacksonville Electric Authority Ym( ) No ( Date: Bell South Telephone Company Yes( ) No ( Date: Ferrell Gas Yes( I No ( Date. Comcast Yes( ) No ( Date: 2. Whenever necessary for the construction. repair, improvement, maintenance, safe and efficient operation, afteration or relocafion of all.or any portion of said street or eamment as determined by the Director of Public Works, any or all of said poles, wines� pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from mid stmat or easement or reset or relocated hereon as required by the Director of Public Works, and at the expense of the Permiltse unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or Florida Oeparbnent of Transportabon Standards and be performed under the supery...... —(Contracbes Prcject Superintendent)located at jBil" —latermonew. 76V-IU�7idt. 4. All materials and equipment shall be subject To Inspection by the Director or Pubbe wom 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. A sketch of plans covering details of this installabon, as well as a Copy of a recent survey shall be made a part of this Calculations shmina any Increase in impervioujis am on owner's tRt or In the clity Right of W=tq be included with this supliollition. 7. This permittes shall Commerce actual Construction in good faith with _days� If the beginning date is mom then 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 harem set out are granted only to the extent of the City's right, tide 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 oetx 5--1(-'5- Belkx."U" we state Of Flon Is,luo pm�ly� N.I.ry PW.M Large,SaID.Of fl�' or� My nNnssion exPirs, —Pmm*Krx� ca".-a— CASSIVADRA K REA MYX)httI0OI#FZ?N47 EXPIRES:Wy 10.W19 BUILDING PERMrr APPIUCATION CITY OF ATLANTIC BEACH goo Seminole Road,Atlantic Beach,FL 32233 Office(904)247-5826 Fax(904)247-5945 JobAddress; PertaftNumlam Legal Description &r 39 Floor PAIrcal# Arco til Ft aq.rx Valuation of Work S (a Proposed 4fork catd1co,led— min-beate"DOWIL— Class of Work(circle one): Alteratim Repair Move Demolition pooVspa. win dow/door Uft of eltiatin structure(s) mleone)* Commercial If an existingir1cm-dis a fire spring,r system installed?(Circle onc)d��- o NIA Florida Product proval# For multiple paucts use product approval tom Describe in detail the type of viork to be perfbrmed�����!�- e��Ire. �Prj Propyrry Ovvner Inforland—ow. E-Mail orFax#(Option Contractor Informatiout Company Name:Cay#AdvtrqS Dc5V t Rl"*kt- Qualifying Agent Address: lac�l bve�A N94. urty mwx�"I� State Pf, —zip 3�yw office;Phone$Plwk 7?A-P7'a- Job Siod Contact Number IoY-7S?-j;a 7o Faxf lqi-"A-0T1V State Certification/Registrafion# Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Bonding Company Narne and Mortgage Under Narne and Address .4pplimlin,is hereby mde to obtain opemite,dodo war*andubstallatiourar haeficaea: I eardfy that nowark or installation has t,ouneenoadinlo,to the hwallwa,kwillbepa, for7uett to met ob,standarde ofall laws regulanitumveruation in th4rjurisdictrom Thisperaul becomes null wo,kiscanumoond jur�de���t�a���mwlbes�df�EJft*i W&*P&uhfrSi9au, elhuPbah, Tank mdAlr Cvufidau�de, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMUENCEMLENT MAY RESULT IN YOUR PAYING TWICE FOR IWROVFN%NTS TO YOUR PROPERTY.IF YOU INTEND TO OBTAIN FINANCING CONSULT WITII YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y6M NOTICE OF COADIENCEMENT. "n' k Signature of 0-- ?r.tNume Sworp,to and subscr me Sviont to and subscribed belbre an, this I I Day of .20 1 f' this I I Day of iew, blic MYC0W1Ss0N#FFWa7 ExPRES:maylo,mig Revised0116.10 R.O.W.Permit Attachinent of for h 419e��7 R.O.W.Permit#-issued 1200 Atlantic Bzf 3,j�pj Owner's Name: 9talw,n 't ft- Property Addrt a: 314 oe�.d Subdivision: Lot#/Block#: 46�-37 R.E. #: REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of f?29W 200Eby Atlantic Beach, Florida, a municipal corporation orgaruzed 'Ing under tl�laws of the State of Florida, hereinafter referred to as '�CITY-and �)'*4&7 of Atlantic Beach,Florida,hereinafter referred to as;"USEW'. VVIJNESSETH: That the CrrY 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: T- em*iv 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 CrrY 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 ofUSER's proper address. The USER shall promptly make my 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, my and all material necessarily displaced during the action of maintaining, repairing, operating,replacing, or adding to of the utilities and facilities ofthe 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 we and code requirements ofthe CITY,including City Code Section 19-7 (h) which states "Driveways dud =as sidewalks: City sidewalks may not be replaced with other materials, but must be replaced with smooth orricrete left =rural in color so that it matches the existing and adjoining sidewalks." Page I of2 The USER, prior to making my 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 inure to the beriefit o� and be binding upon, the USER and their respective successon;and assigns. USER shall meet the terms arid 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 my of the work herein under the terms of this permit and that all of said liabilities are hmby assurned by the USER. DATED and SIGNED this t 4 day of 20OX7 By: Z�'-/- - Property Owner (to be signed in presence of the Notary) STATE OF FLORIDA COUNTY OF DUVAL On this 14 day of Mat, 200_,rpersonally appeared before me, a Notary Public in and for said County and State, � 'Pkrj� I 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 fireely and voluntarily and for the uses and purposes therein mentioned. Notary Public in for said i ounty and State EXPIRES:May 10,21119 CITY OF ATLANTIC BEACH,FLORIDA,a Rai m=.,Y municipal corporation: Approved: Doug Layton,Public Works Director For Permits where city sidewalk is impacted, City Manager approval required: Nelson Van Lim,City Manager Page 2 of 2 cm cm lltd WUI z 14 i 20 U 11 It 11 11 g� cc lw Li zip 1p It p; Psi! c L lot w M(o t�LU . . . . . . . . VV� 93 to A Id 4i py Qt 14 M-i (ov./15;7 7 .4v "OFIA ii Rn", Cz co .. .. .. .. .. .. 'd.7t I ZONING REVIEW COMMENTS City of Atlantic Beach Building and Zoning Department 800 Seminole Road Atlantic Beach,Florida 32233-5445 Phone: (904)270-1605 Fax: (904)247-5845 Email: dreeves@coab.us Permit: 15-DWAY-1 192 Applicant: Earth Works Review: I st Address: 12501 Beach Blvd, Jacksonville, FL 32246 Site Address: 313 Oceanwalk Dr S Phone: (904)996-0712 RE4: 169463-0578 Email: N/A Correction Comments 1. Tree Removal: Please submit a Tree Removal Permit Application if any trees we to removed. If no trees are to be removed,then please fill out an Affidavit of No Tree Removal. Both finnis are available on the city website under"Planning and Zoning"and at City Hall. 512j,p -5pa)ct- -to 1DOU9 Derek W. Reeves re�rfl- qf)\�+rtcs- Zoning Technician CvvrldooAto dreeves@coab.us City of Atlantic Beach Building Department Se"'inole Road Plant1 Besc jor c h, F ida 32233- 445 E hone(9 247�5 F8X(59W)247-5845 _",I 1, ildl, _ , City a _'It, I g filn,�b b '10 7 Cost, APPLYCATPON REVIEW AND TRACKYNG FORM PrOPerty Addre 09 Z14&ah A�,C _s Department r Applicant* Buildin law required Ye. fqo annin &Zonin Project- ree Hustrator Public Wor U Ic eii&tm r Public Fire SeNicas Review fee $ Dept Signature Other Agency Review or Permit Required REvieW or Receipt Florida t of Environm,, I P,,Laclirr Of Permit Verified Date Florida I.of Transportaff, St Johns River Water Me"ago'hent District Army Curtis of Engineers Division of Hotels and Restaurarth Division OfAlwholic Bwaregas and Tobacco Other. Reviewing DOPRItment First Review: APPLICATION STATUS (Circle one.) Comments: EIAPProved Aerved, BUILDING fe,e 414Az4,) �LANNING&ZONING TREEADMIN. Reviewed by:-A 4"A-1 Second Revie : CIAPProved as revised. Date: PUBLIC WORKS Comment,, DDenjed. WORKS PUBLIC UTILITIES PUBLIC SAFETY Reviewed by FIRE SERVCFS Third Review: [3Apprwed as Date Comment,: revised, DDenied. Rewevvecl by Date- 107127/10 R.O.W. Permit Attachment of for R-O-W. Permit# issued for 3 gg74� 200 Atlantic Beach 3,� - 1? 4h Owner's Name: Property Address: 113 Subdivision: MAY I Lot#/Block M: 1-61,-12, R.E. tf: By M] REVOCABLE ENCROACHMENT PERMIT THIS REVOCA13LE ENCROACHMENT PERMIT, issued on this tf day of -77�v 200-firy Atlantic Beach, Florida, a municipal corporation organized�tex ting under th�laws of the State of Florida, hereinafter referred to as "CITY"and 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: X y- --414 Wd�, �*- 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 my and all necessary repairs to my 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-descubed 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,replacin& 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 Ind use and code requirements of the CITY,including City Code Section 19-7 (b) which states "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but most be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks." Pagel of2 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, fbr 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 more 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 aral/or specifications, to include utilities locate requirements and use limitations/requirements of public rights-of-way and other pubfic land. USER further agrees that the CITY and its officers and employeea shall be saved harmless by the USER fiOm arY 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 t 4 day of 2004.7 By: 4, z— FroPerty Uwner (to be signed in presence of the Notary) STATE OF FLORIDA COUNTY OF DUVAL On this J-4-- day of 200 ersonally appeared before me, a Notary -Co�untymd Stae, Public in and for said 4�p K the property owner of 7— Atlantic Beach, Florida, known to me to be the peraon(s) described in and who ex�uted 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. IDRI fl Notary Public in for said Counq MYC= t8so'IFFLI .6XPIRES may 10,2019 and State CITY OF ATLANTIC BEACH,FLORIDA,a municipal corporation: Approved: Doug Layton,Public Works Director For Pennits where city sidewalk is impacted, City Manager approval required: Kelson Van Licre,�City Manager Page 2 of 2 CITY OF ATLANTIC BEACH CONSTRUC]ION PERMIT WITHIN CITY RIGHTSOFWAYAND EASEMENTS M Sendriole R*ad 9�247-58N Mart.�di.R.rd.32233�5 904-247-SW PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION. Date S///115- p-IT Job Add. ,�� 1-3 6b%AWOJX 01. ':R Pe"Itee: S�e*, �LrK Telephortalli Families Address: 313 Creli-W&AK br.f. RequesfingP�issiontoConstmut:��e, Location: (Reference to w-,4 - "F3--je-T-aoA Tr,, 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 locadons am shown on the sketches. A Letter of Notification was mailed to the following 1.1filifiesimunicipalifies: Jacksonville Electric Authority Yes( I No I I Date: Bell South Telephone Company Yes( No Date. Ferrell Gas Yes( No Date: Gomcast Yes( No Data. 2. Whenever necessary for the construction, repair, improvement, maintenance safe and efficient operation, afteration 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 met 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 Aflantic Beach or Florida 42-lartment of Transportation Standards and be performed under the supervision of 11�1 IN (Contractors Prcject Superintendent)located at C� �K% %*a Vft�wt, ---- Telephonelk. '10-TW-o7la. 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 conchon as far As practical, in keeping with cry,specifications and the manner satisfactory to the city. 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 perrint. Calculations showima any Incrialism in imporyfous area an owner's lot"In the CAY Pight of Way am to be Included with this opplicittion, 7. This pernnittee shall commience actual construction in good faith with _days. If the beginning date is mom than 60 days from date of perinit approval,then permithee 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 am 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, darnAge, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid(ights and privileges. S. The Director of Public Woft shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion. OWNER �0 / Sf,niid /a^,,? - oets, $--I(-f5' or vval' sise wliift it. iirfty.� NotuyPUbUCe�gB,S�gR�a,�n[YW�t. slymnionissionexpim: personally KrD.:C4"'-'a— Pmdu=1 Iderfiffimill.: AAR W ISSION If AF 222947 EX?lflES:Mayl0,W9 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BFAcjEi 800 Seminole Road,Atlantic Beach,FL 32233 Offi�(904)247-5826 Fax(904)247-5845 Permit Numb": JobAddress: , 's Legal Description 1�r 3.? rworArea 'q Ft�dlcooledl parcelit 'u'o�'-theatetticoold Valuation of Work S a 1,(b Proposed 4iork he�t Class of Work(circle one): (94 <ig� Alteration Repair Move Demolition poollspa window/door Use of exisfin=wd atructure(S�Zle one): Commercial es*denti Iran existlog c reisafirespra er system installed. (Circle cme)(: N/A Florida Product proval# For multiple paucts use-product spp-M-M farm Describe in detail the type of work to be performed:T�,,e v Ariveitwi3 �pAwer Property Owner Information: Name: Address: ';V?� (Oeft-ftw"r StltiviLzlpl -Phone lcq -qqE!6�F73 City E-Matloffax4 Contractor Information; Company Name:CaHMAorPs &5* ftlo-hf. Qualifying Agem: Addreas� IaLS&i &,�A PA,4- -city M��Qf. State Pl- Z' 3%ayd Office Phone$Q97 �71jk. JobSite/ContactNuttber fay-v"-Ca7v Fax� State Cerfification/Registration# Architect Name&Phone# Engineer's Namo&Phone 4 Fee Simple Tide Holder Name and Address Bonding Company Name and Address Mortgage tender Name end Addms =o ,f,l=itandth�allworkwillbep.&Y�.dta�ettlwstandardsofagi�mgukdxgeonj&7�-tkn in Wsjurisoftenion. Thupmnit becomes null not cmwo�dwfthho.,L,(6)n000lm,orif contmoaon orwo,kis fddor.b..doex(fbra oiad.f,&j6).o,uAat.,d. T,anb .dAhr CVngdofi�do fl= worko,,Zvn000�d W'.*,F&nobigS4hM whftiok rnw�,BoiZkff WARNING TO OWNER. YOUR FAILURE TO RECORD A NOTICE OF COMMIENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IWROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITTI YOUR LENDER OR AN ATTORNEY BEFORE RECORDING VO-M NOTICE OF COADIENCEMENT. "on ��kt th ah-�P Sigamma of 0_ PrmtNamc Swona�to and mbscribo��fcsv me Sworn to end Subscribed before me this H Day of rna'j 20 f' ffiis ) Day of A� .20 --- (111AA Notary Public GOSSANDIRRAR 0 blic MYCONNISS01#722MI EXPIRES:May 10,�19 knised0l.26.10 cc ---Tj IT I coo C - 44 8, 4-1 Is OZ ............-tj AP ca Hill t- Run LIM-- A-i C�lzl�V: 1 0 0 9 A .4 0 P 0 u 7 ! 0 6 ca YL 15A. i!twi 'A Q4 vm. 4i to AM&; to rn �O 7 TREE & VEGETATION AFFIDAVIT City of Atlantic Beach Department of community Development Planning&Zoning Division 800 Seminole Road Atlantic Beach,FL 32233 (P)904 247-5800 F)904 247-5845 PERMIT# SECTION I-APPLICANT INFORMATION r— Owner(s) r— Legal Authorized Agent- NAME OF APPLICANT —)er is ) NAME OF COMPANY VL)12ryC ADDRESS OF COMPANY V.11 PHONE _ d.7jr, CELL EMAIL _,Wnrj<S 49 64�— .C', CONTRACTOR CERTIFICATION NUMBER ATLBCH BUSINESS TAX RECEIPT NUMBER SECTION 11-SITE INFORMATION STREET ADDRESS OF PROPERTY ifanatliireu hmwt�n anigmdmffiisp�r�6�taOMeASBuilding��"mtat(PtQ247-5V6 toru;w0w�dn,'s. LEGAL DESCRIPTION LOT BLOCK SUBDIVISION REAL ESTATE NUMBER LOT OR PARCEL SIZE: 50 FT AC RESIDENTIAL COMMERCIAL OTH ER(SPECIFY) I affirm that I have reviewed the provisions of Chapter 23, 'Protection of Tmes and Native Vegetation-of the Municipal Code of Ordinances for the City of Atlantic Beach,FL andlor I have participated in a pre-application meeting with the Administrator of those regulations. Subsequently,I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and(or removed from the above-describ radjacc tp cony.unction with this project SI ATUREOP&AWER� SIGNATURE OF OWNER Signed and sworn before me on by State of WIT"; I County of Identification verified: F:�' )->L, Oath sworn: r— Yes I-L-wo ry jjgture U EXPIRES.APA N.2017 My Commission expires: CitY of Atlantic Reach 4f4Y,2 60ding Department Aso A APPLICA I N U BET? 800 Smincle R,,d Atlantic Beach, Florida 32233. assigned by th 81111110 D 0 ent) Phone(904)247-S�M I,.0 --' (TO be 1. 4)24 -58 S - ht"ding 5"� 'y' Efall -"ccob CltYwc�b-site U5 oab,us Date muted: APPLOCATUON REVIEW AND TRACKING FORM i"rOPOrtY 7di�T?ss, IeWre uired Yes APplicant: it rev' No Project: a nin &Zoni e nwn,sh,to, Public if U JIC Public fety Fire Services Review fee $__ Dept SignatUre Other Agency Review or itRequird Review r elpt Flo ,Dept of EnvnP of Permit Oriffed 8 Date Flo Dept of T'Mrsportation Prot on 81, rS R ver Water Maragment District C a of Engineers Division Of Hotels and Restaurants DhAsi-Of AlwhNic Bevwg.and Tobacco Other. APPLICATION STATUS Reviewing Department —�, �I A I t (Circle o,,,) First Re,i,,: �U. led Comments: BUILDING C-LC-Ao- L- 14-6-1 IJ 'LANNING&ZONING U444 7 t AJ .7 L)tXi F TREEADMIN Reviewed by: Date 2,1 Second Review. �3APProved as revised. d PUBLICWORKS comments: PUBLIC UTIL17JES PUBLIC SAFETY Reviewed by 9RE SERVICES .Third comments. L-166nied. Reviewed by- PUBLIC WORKS PLAN REVIEW COMMENTS Date: -�-W I I�;- Application Permit#: IS- 4uliY �11qz Project Name/Address: 31 -� DCO�o L-W kba= �, , ,,0 Check Box to Application Tracking Comments select 'ORRECTION ITE MS: C,M, �Provlde construction site management plan, including location of dumpster and portable toilet, Right- f-Way Permit is required if using right-of-way for construction parking. 0 DPLN rovide drainage plans showing site topography(flow arrows,etc..)) 0 ESCP rovide erosion and sediment control plans with installation details. 0 IMPS rovide impervious surface calculations for entire lot(existing and post construction). 0 ection 24-66(b)of the Land Development Regulations requires on-site storage for Increased run-off if LDCS dding 400 SFor more impervious surface. Provide Delta volume calculations and on-site retention 0 equired per Section 24-66(b). (See attached information sheet.) MEET lRecommend Owner/Contractor meet with Public Works Director to discuss proposed construction. PH 247-5834 to make an appointment. 0 REPM Revocable Encroachment Permit must be obtained. 0 RMRO It runoff must remain on-site. Cannot raise lot elevation without measures to retain runoff. 0 RWPIV1 Right-of-Way Permit must be obtained for use 0 TSUR rovide a pre-construction topographic survey prepared by a Florida Licensed Professional Land urveyor,showing I'contours. 13 NDITIONS OF APPROVAL TO PRINT ON PERMIT: It concrete driveway aprons must be S�thick,4000 psi,with fibermesh from edge of pavement to the DAPR roperty,line. Reinforcing rods or mesh are not allowed in the right-of-way. (Commercial driveways— 0 "thick.) rul!erosion control measures must be Installed and approved prior to beginning any earth disturbing ECIN �ctrvities. Contact Public Works(247-5834)for Erosion and Sediment Control Inspection prior to start PCORU�10 OSRO mus main on-site during construction. 0 PCTS f on-site storage is required,a post construction topographic survey documenting proper construction Ill be re uIred. 0 PLWP ool—Wellpoint(if used)must discharge Into vegetated area 10'minimum from street or drainage eature(swale,structure or lagoon). A separate pool permit Is required. 0 ROFF oil off container company must be on City approved list and container cannot be placed on City right- _way. Approved:Advanced Disposal, Realco Recycling,Republic Services,Shappel's and Waste Pro). RWRS ull right-of-way restoration,including sod,is required. URCT ny utility cuts in the road must be repaired using COJ Standard Detail Caw X and must be overlaid 10 eet in each direction from the center of the cut. Repair must be shown on the plans.