1589 MAIN ST -RIGHT OF WAY CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RIGHT OF WAY PERMIT
MUST CALL BY 4PM FOR NE)lT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 14-ROW-158
Job Type: RIGHT-OF-WAY PERMIT
Description: DWAY, CULVERT, REPLACE SIDEWALK
Estimated Value:
Issue Date: 615/2015
Expiration Date: 12/212015
PROPERTY ADDRESS:
Address: 1589 MAIN ST
RE Number: 172321-0000
PROPERTY OWNER:
Name: CERQUEIRA,ATILLION & CATHERINE,
Address: 36 W 6TH ST
PERMIT INFORMATION: PUBLIC WORKS:
Full right-of-way restoration, including sod,is required.
"Work already completed,but plan provided does not show what was proposed.
FEES:
Fence/ROW $35.00
Total Payments: $35.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
0 CONSTRUCTION PERMITWITHIN CITY RIGHTS OFWAY kND EASEM
800 Serninole Road 9
JF7 Atlantic Beach,Runde 32233,1445 Fax 9 7-5 0 7 2
�ft
4
PLEASE SUBMIJ�J*COMPLIETE SETS OF PLANS WITH APPLICATION.
Date 49C t- PERMrr* _�o
ISSUED RY _rry KO Z)
Job Address 9 /17/V"-11 THE CITY 14
6 72-T
Peml ee g/ rf Telephone# o2 Ar7l_� S 7er 2. gr gT
Permittee Address:—9( L�0-r, S2 V 2 7
R?q,,s1,ng,P,enmIssioi�2nslrucl: A2 ge f',Z 11'WZf �4 1 ctj 1�e A 7il- PC 2, 77,C�
Location: (ReferencetoCross-Street) Oe-Wyjyj 1��4,9,Lt V �- I-
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 am shown on the sketches.
e,,v c /f J`-e rr ii kr
A Letter of Notification was mailed to the following Utilities/Municipalities: 7 r <td,e4il--
Jacksonville Electric Authority Yes( No Date: ZO 7 ley
Bell South Telephone Company Yes No Date:
Ferrel[Gas Yes No Date:
Commst Yes No Date:
2. Whenever necassuary, for the construction, repair, Improvement maintenarim, 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, winesi, pipes, cables or other facilities and appurtenances authorized
hereunder, shall be immediately removed from said streart or easement or meet 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 &,11 X e e (Contractor's Project
Superintendent) located at ' Telephone* e J—jr—4l; 7�2
4. All materials and equipment shall be subject to inspection by th—
a 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.
S. 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 lnGMse in Impervious.ral on owner's, lot or In the city
Right of Afary are to be included with this apolficattlon.
7. This permittee shall mmi-nence actual construction in good faith With days. If the beginning date is
mom than 60 days from date of permit approval, then permittee must review the permit with the Director of
Public Works to make sum no changes have occurred in the area that would affect the permitted construction.
B. It is understood and agreed that the rights and privileges hemin 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 tie holder, and the Holder will, at all
times, assume all risk of and indemnify, defend, and save harmless thR City of Atlantic Reach 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: Date: /OA7 /d V
Before me this V ;09- aYGf OZ�41" the County of Duval,
State OfFlonda,has penionallyappared
Notary Public at Large,State of Flo)fda,(iounty of Duval.
My commission explies: /9/21//jE enaonx4m
Produced identification-
City of Atlantic Beach APPLICATION NUMBER
Building Departme (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach,Florida, 3-5445 N.011 9 6 mill 14- RQL,6 -61�
Phone(904)247-5826 ix(904)247 5845 --
City web-site: hHIPJPwww oalbus I p)- Date muted:
APPLICATION REVIEW AND TRACKING FORM
Property Address: 15eq m4h sik-_ Department review required Yes No
Building
Applicant: Nl � kecvcs Planning&Zoning
Tree Administrator
Project: C,64 W��T� Public Wor-k§
3
PuNic Utilities
,eublic Safety
re Services
Review fee $
71��I— Dept Sgnatu�.
CONTRACTOR EMAILf �DRESS
CONTRACTOR CONTAU #
APPLICATION STATUS
Reviewing Department First Review: pproved. ElDenied.
(Circle one.)
BUILDING Comments:
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Rev., E]Approved as revised. E]Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: —Date:
FIRE SERVICES
Third Reviler DApproved as revised. F]Denied.
Comments:
Reviewed by: —Date:
REVISED 09252014