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2321 MAYPORT RD - DOLLAR TREE DOC. City of Atlantic Beach APPLICATION NUMBER M„ (To be aslign d by the Building Department.) r1 Building Department D / "� • �� Sinol )t \'( Atlantic Beach, Florida 32233-54$5 Phone(904)247-5826 • Fax(904)247-pft11, 0 3 2015 Date routed: �1 /�S E-mail: building-dept @coab.us City web-site http 11www coab.ust, , APPLICATION REVIEW AND TRACKING FORM 32 "peer £c/ •epactmnt review required Yes No Property Address: � :u .�., B Planning &Zonin• Applicant: ✓✓✓ I ree Pdministrator JJ�r. is (Public WoProject: _ ���/// 71-f ��- • Util �� Public Safety Fire Services nature r'-'\(\ �w or Receipt Date w it Verified By St.Ar. Army Division 4.)\1/ Division 0. Other: ..,ATION STATUS _ Reviewing Department First I ❑Approved. ADenied. (Circle one.) Comma.Ics: .721E vi o�. S v.A+-y+- F_ 4,-/--5 -1.0.647r Al t BUILDING PLANNING&ZONING Reviewed by: Date: 2 N �r TREE ADMIN. Second Review: ['Approved as revised. [Denied. PUBLIC WORKS Comments: /Piet:. � n � t i/d , s rilikA. . /►'.71 PUBLIC UTILITIES �r`' `v� /v vv PUBLIC SAFETY Reviewed by: Date: Zia-- FIRE SERVICES Third Review: Approved as revised ['Denied. Comments: dr r A Reviewed by: Date: C� A — 1 Revised 07127/10 3 ?T>r•1/‘lf6 J CITY OF ATLANTIC BEACH L1 DEPARTMENT OF PUBLIC WORKS 1200 Sandpiper Lane f) Atlantic Beach,FL 32233-4318 TELEPHONE:(904)247-5834 FAX:(904)247-5843 013 � www.coab.us CONTRACTOR: DATE: 3-19-2015 CDA Holdings, LLC. PERMIT#14-CNEW-536 C/O Dynamic Commercial ADDRESS: 2321 Mayport Rd. 1 Commercial Center Virginia Beach,VA 23463 EMAIL: drbushey @dynamiccommercial.com PERMIT APPLICATION FOR DOLLAR TREE The Public Works Department review for your building permit#15-CNEW-536 has been completed and approved. This is not the final approval for the building permit. Once all required departments have reviewed your application,and the permit is fully approved,you will be notified by the Building Department. PUBLIC WORKS CONDITIONS OF APPROVAL: (The following comments will be printed on your permit as Conditions of Approval) *A Revocable Encroachment Permit must be obtained. *AII concrete driveway aprons must be 5"thick,4000 psi,with fibermesh from the edge of pavement to the property line. Reinforcing rods or mesh area not allowed in the right-of-way. (Commercial driveways-6"thick). *Full right-of-way restoration, including sod,is required. *Roll off container company must be on City approved list and container cannot be placed on City Right-of-Way. (Approved:Advanced Disposal, Realco Recycling, Republic Services,Shapell's and Waste Pro.) *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. I cc: Jennifer Walker, Bldg. Dept. .'S li- CITY OF ATLANTIC BEACH J �� DEPARTMENT OF PUBLIC WORKS `s` 1200 SANDPIPER LANE -- - ATLANTIC BEACH, FLORIDA 32233-4318 TELEPHONE: (904) 247-5834 -5`111"\_.. __Y12.-5 FAX: (904) 247-5843 SUNCOM: 852-5834 .'-1- 0.11.1�r www.coab.us CONTRACTOR: DATE: 2-17-2015 CDA Holdings, LLC. PERMIT# 14-CNEW-536 C/O Dynamic Commercial ADDRESS: 2321 Mayport Rd. 1 Commercial Center Virginia Beach, VA 23463 EMAIL: drbushey @dynamiccommercial.com PERMIT APPLICATION FOR DOLLAR TREE Your permit application has been denied by the Public Works Department for the reasons listed below. Please submit this information at your earliest convenience in order that we may approve your application. If you have any questions, please contact Doug Layton, Public Works Director at 904-247-5834 or email dlayton @coab.us. PUBLIC WORKS CORRECTION ITEMS: (Submit the following information to the Public Works Department) * • .v'P opy if ' 4 M s • •• • • on . •plication. **Prove. • • s of FDA 'OW C-nnection Permit. PUBLIC WORKS CONDITIONS OF APPROVAL: (The following comments will be printed on your permit as Conditions of Approval) *A Revocable Encroachment Permit must be obtained. *All concrete driveway aprons must be 5" thick, 4000 psi, with fibermesh from the edge of pavement to the property line. Reinforcing rods or mesh area not allowed in the right-of-way. (Commercial driveways-6"thick). *Full right-of-way restoration, including sod, is required. *Roll off container company must be on City approved list and container cannot be placed on City Right-of-Way. (Approved: Advanced Disposal, Realco Recycling, Republic Services, Shapell's and Waste Pro.) *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 cc: Jennifer Walker, Bldg. Dept. Pti\I RECEIVED MAR 17 2015 Provide copy of SJRWMD modification application. BY: Provide copy of FDOT ROW Connection Permit. E AR16 - • , By ,�.�.A,•' St. Johns River ' Water Management District 'M'^'�o..++•'` • Hans G.Tanzler III.Ereculrve Director 4049 Reid Street • P.O.Box 1429 • Palatka,FL 32178-1429 • (386)329-4500 On the Internet at ftoridaswater.com. February 27, 2015 CDA Holdings, LLC Ste 600 1 Columbus Ctr Virginia Bch, VA 23462-6760 SUBJECT: Permit Number 37016-2 Dollar Tree - Mayport Rd. Dear Sir/Madam: Enclosed is your individual permit issued by the St. Johns River Water Management District on February 27, 2015. This permit is a legal document and should be kept with your other important documents. Permit issuance does not relieve you from the responsibility of obtaining any necessary permits from any federal, state, or local agencies for your project. Technical Staff Report: If you wish to review a copy of the Technical Staff Report (TSR) that provides the District's staff analysis of your permit application, you may view the TSR by going to the Permitting section of the District's website at floridaswater.com/permitting. Using the "search applications and permits" feature, you can use your permit number or project name to find information about the permit. When you see the results of your search, click on the permit number and then on the TSR folder. Noticing Your Permit: For noticing instructions, please refer to the noticing materials in this package regarding closing the point of entry for someone to challenge the issuance of your permit. Please note that if a timely petition for administrative hearing is filed, your permit will become nonfinal and any activities that you choose to undertake pursuant to your permit will be at your own risk. Compliance with Permit Conditions: To submit your required permit compliance information, go to the District's website at floridaswater.com/permitting. Under the "Apply for a permit or submit compliance data" section, click to sign-in to your existing account or to create a new account. Select the "Compliance Submittal" tab, enter your permit number, and select"No Specific Date" for the Compliance Due Date Range. You will then be able to view all the compliance submittal requirements for your project. Select the compliance item that you are ready to submit and then attach the appropriate information or form. The forms to comply with your permit conditions are available at floridaswater.com/permitting under the section "Handbooks, forms, fees, final orders". Click on forms to view all permit compliance forms, then scroll to the ERP application forms section and select the applicable compliance forms. Alternatively, if you have difficulty finding forms or need copies of the appropriate forms, please contact the Bureau of Regulatory Support at (386) 329- 4570. Transferring Your Permit: Your permit requires you to notify the District in writing within 30 days of any change in ownership or control of the project or activity covered by the permit, or within 30 days of any change in ownership or control of the real property on which the permitted project or activity is GOVERNING BOARD John A.Miklos.cEwnwln Fred N Roberts Jr.,.ncs CHAIRMAN Chuck Drake,swam,' Carla Yeller,TREASURER ORLAIUO OCALA Daimon FERNANDONA BEACH Douglas C.Boumique Douglas Burnett Lad Daniels Maryam M.Ghyabi George W Robbins vino BEACH ST AUOUSTIIR ,ACXSONV1LLE ORMOND BEACH JACKSOPnIllE ST. JOHNS RIVER WATER MANAGEMENT DISTRICT Post Office Box 1429 Palatka, Florida 32178-1429 PERMIT NO: 37016-2 DATE ISSUED: February 27, 2015 PROJECT NAME: Dollar Tree - Mayport Rd. A PERMIT AUTHORIZING: Construction of a Stormwater Management System with stormwater treatment by Dry Detention with Underdrain for Dollar Tree - Mayport Rd., a 1.86 - acre project to be constructed and operated as per plans received by the District on February 12, 2015. LOCATION: SECTION(S): 8 TOWNSHIP(S): 2S RANGE(S): 29E Duval County ISSUED TO: CDA Holdings, LLC Ste 600 1 Columbus Ctr Virginia Bch, VA 23462-6760 The permittee agrees to hold and save the St. Johns River Water Management District and its successors harmless from any and all damages, claims, or liabilities which may arise from permit issuance. Said application, including all plans and specifications attached thereto, is by reference made a part hereof. This permit does not convey to the permittee any property rights nor any rights or privileges other than those specified herein, nor relieve the permittee from complying with any law, regulation or requirement affecting the rights of other bodies or agencies. All structures and works installed by permittee hereunder shall remain the property of the permittee. This permit may be revoked, modified or transferred at any time pursuant to the appropriate provisions of Chapter 373, Florida Statutes. PERMIT IS CONDITIONED UPON: See conditions on attached "Exhibit A", dated February 27, 2015 AUTHORIZED BY: St. Johns River Water Management District Division of Regulatory, Engineering and Environmental Services By: David Miracle Service Center Director 7. If the final operation and maintenance entity is a third party: a. Prior to sales of any lot or unit served by the activity and within one year of permit issuance, or within 30 days of as-built certification, whichever comes first, the permittee shall submit, as applicable, a copy of the operation and maintenance documents (see sections 12.3 thru 12.3.3 of Volume I) as filed with the Department of State, Division of Corporations and a copy of any easement, plat, or deed restriction needed to operate or maintain the project, as recorded with the Clerk of the Court in the County in which the activity is located. b. Within 30 days of submittal of the as- built certification, the permittee shall submit "Request for Transfer of Environmental Resource Permit to the Perpetual Operation Entity" [Form 62-330.310(2)] to transfer the permit to the operation and maintenance entity, along with the documentation requested in the form. If available, an Agency website that fulfills this transfer requirement may be used in lieu of the form. 8. The permittee shall notify the District in writing of changes required by any other regulatory District that require changes to the permitted activity, and any required modification of this permit must be obtained prior to implementing the changes. 9. This permit does not: a. Convey to the permittee any property rights or privileges, or any other rights or privileges other than those specified herein or in Chapter 62-330, F.A.C.; b. Convey to the permittee or create in the permittee any interest in real property; c. Relieve the permittee from the need to obtain and comply with any other required federal, state, and local authorization, law, rule, or ordinance; or d. Authorize any entrance upon or work on property that is not owned, held in easement, or controlled by the permittee. 10.Prior to conducting any activities on state-owned submerged lands or other lands of the state, title to which is vested in the Board of Trustees of the Internal Improvement Trust Fund, the permittee must receive all necessary approvals and authorizations under Chapters 253 and 258, F.S. Written authorization that requires formal execution by the Board of Trustees of the Internal Improvement Trust Fund shall not be considered received until it has been fully executed. 11.The permittee shall hold and save the District harmless from any and all damages, claims, or liabilities that may arise by reason of the construction, alteration, operation, maintenance, removal, abandonment or use of any project authorized by the permit. 12.The permittee shall notify the District in writing: a. Immediately if any previously submitted information is discovered to be inaccurate; and b. Within 30 days of any conveyance or division of ownership or control of the property or the system, other than conveyance via a long-term lease, and the new owner shall request transfer of the permit in accordance with Rule 62-330.340, F.A.C. This does not apply to the sale of lots or units in residential or commercial subdivisions or condominiums where the stormwater management system has been completed and converted to the operation phase. two years thereafter to determine if the system is functioning as designed and permitted. The operation and maintenance entity must maintain a record of each required inspection, including the date of the inspection, the name, address, and telephone number of the inspector, and whether the system was functioning as designed and permitted, and make such record available for inspection upon request by the District during normal business hours. If at any time the system is not functioning as designed and permitted, then within 30 days the entity shall submit to the District form number 62-330.311(1), and mark of the form the appropriate notation describing the status of the system. 24.Prior to commencing construction, the permittee must provide proof of ownership of the real property upon which the authorized activities will be implemented. 25.This permit does not authorize any wetland or surface water impacts. Notice Of Rights 4. A petition for an administrative hearing is deemed filed upon receipt of the complete petition by the District Clerk at the District Headquarters in Palatka, Florida during the District's regular business hours. The District's regular business hours are 8:00 a.m. — 5:00 p.m., excluding weekends and District holidays. Petitions received by the District Clerk after the District's regular business hours shall be deemed filed as of 8:00 a.m. on the District's next regular business day. The District's acceptance of petitions filed by e- mail is subject to certain conditions set forth in the District's Statement of Agency Organization and Operation (issued pursuant to Rule 28-101.001, Florida Administrative Code), which is available for viewing at floridaswater.com. These conditions include, but are not limited to, the petition being in the form of a PDF or TIFF file and being capable of being stored and printed by the District. Further, pursuant to the District's Statement of Agency Organization and Operation, attempting to file a petition by facsimile is prohibited and shall not constitute filing. 5. Failure to file a petition for an administrative hearing within the requisite timeframe shall constitute a waiver of the right to an administrative hearing. (Rule 28-106.111, Florida Administrative Code). 6. The right to an administrative hearing and the relevant procedures to be followed are governed by Chapter 120, Florida Statutes, Chapter 28-106, Florida Administrative Code, and Rule 40C-1.1007, Florida Administrative Code. Because the administrative hearing process is designed to formulate final agency action, the filing of a petition means the District's final action may be different from the position taken by it in this notice. A person whose substantial interests are or may be affected by the District's final action has the right to become a party to the proceeding, in accordance with the requirements set forth above. 7. Pursuant to Section 120.68, Florida Statutes, a party to the proceeding before the District who is adversely affected by final District action may seek review of the action in the District Court of Appeal by filing a notice of appeal pursuant to Rules 9.110 and 9.190, Florida Rules of Appellate Procedure, within 30 days of the rendering of the final District action. 8. A District action is considered rendered, as referred to in paragraph no. 7 above, after it is signed on behalf of the District and filed by the District Clerk. 9. Failure to observe the relevant timeframes for filing a petition for judicial review as described in paragraph no. 7 above will result in waiver of that right to review. NOR.Decision.DOC.001 Revised 12.7.11 NOTICING INFORMATION Dear Permittee: Please be advised that the St. Johns River Water Management District will not publish a notice in the newspaper advising the public that it has issued a permit for this project. Newspaper publication, using the District's notice form, notifies members of the public of their right to challenge the issuance of the permit. If proper notice is given by newspaper publication, then there is a 21-day time limit for someone to file a petition for an administrative hearing to challenge the issuance of the permit. To close the point of entry for filing a petition, you may publish (at your own expense) a one- time notice of the District's decision in a newspaper of general circulation within the affected area as defined in Section 50.011 of the Florida Statutes. If you do not publish a newspaper notice to close the point of entry, the time to challenge the issuance of your permit will not expire and someone could file a petition even after your project is constructed. A copy of the notice form and a partial list of newspapers of general circulation are attached for your convenience. However, you are not limited to those listed newspapers. If you choose to close the point of entry and the notice is published, the newspaper will return to you an affidavit of publication. In that event, it is important that you either submit a scanned copy of the affidavit by emailing it to cornpliancesupport @sjrwmd.com (preferred method) or send a copy of the original affidavit to: Margaret Daniels, Bureau Chief Bureau of Regulatory Support 4049 Reid Street Palatka, FL 32177 If you have any questions, please contact the Bureau of Regulatory Support at (386) 329- 4570. Sincerely, Margaret Daniels, Bureau Chief Bureau of Regulatory Support NEWSPAPER ADVERTISING ALACHUA BAKER The Alachua County Record, Legal Advertising Baker County Press, Legal Advertising P. O. Box 806 P. O. Box 598 Gainesville, FL 32602 Maclenny, FL 32063 352-377-2444/fax 352-338-1986 904-259-2400/fax 904-259-6502 BRAFORD BREVARD Bradford County Telegraph, Legal Advertising Florida Today, Legal Advertising P. O. Drawer A P. O. Box 419000 Starke, FL 32901 Melbourne, FL 32941-9000 904-964-6305/fax 904-964-8628 321-242-3832/fax 321-242-6618 CLAY DUVAL Clay Today, Legal Advertising Daily Record, Legal Advertising 1560 Kinsley Ave., Suite 1 P. O. Box 1769 Orange Park, FL 32073 Jacksonville, FL 32201 904-264-3200/fax 904-264-3285 904-356-2466/fax 904-353-2628 FLAGLER INDIAN RIVER Flagler Tribune, do News Journal Vero Beach Press Journal, Legal Advertising P. O. Box 2831 P. O. Box 1268 Daytona Beach, FL 32120-2831 Vero Beach, FL 32961-1268 386-681-2322 772-221-4282/fax 772-978-2340 LAKE MARION Daily Commercial, Legal Advertising Ocala Star Banner, Legal Advertising P. O. Drawer 490007 2121 SW 19th Avenue Road Leesburg, FL 34749 Ocala, FL 34474 352-365-8235/fax 352-365-1951 352-867-4010/fax 352-867-4126 NASSAU OKEECHOBEE News-Leader, Legal Advertising Okeechobee News, Legal Advertising P. O. Box 766 P. O. Box 639 Fernandina Beach, FL 32035 Okeechobee, FL 34973-0639 904-261-3696/fax 904-261-3698 863-763-3134/fax 863-763-5901 ORANGE OSCEOLA Sentinel Communications, Legal Advertising Little Sentinel, Legal Advertising 633 N. Orange Avenue 633 N. Orange Avenue Orlando, FL 32801 Orlando, FL 32801 407-420-5160/fax 407-420-5011 407-420-5160/fax 407-420-5011 PUTNAM ST. JOHNS Palatka Daily News, Legal Advertising St. Augustine Record, Legal Advertising P. O. Box 777 P. O. Box 1630 Palatka, FL 32178 St. Augustine, FL 32085 386-312-5200/fax 386-312-5209 904-819-3436 SEMINOLE VOLUSIA Seminole Herald, Legal Advertising News Journal Corporation, Legal Advertising 300 North French Avenue P. O. Box 2831 Sanford, FL 32771 Daytona Beach, FL 32120-2831 407-323-9408 (386) 681-2322 RULE 14-86.004.F.A C STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION DRAINAGE CONNECTION PERMIT ROADW e�EAY DESIGN 10/08 Page 1 of 8 To be completed by DOT Drainage Connection Permit No. 15D2940004 Date 1/28/15 Received By Richard Prindiville Maintenance Unit 294-Jacksonville Maintenance Permits State Road No. 101/A1A Work Program Project No. Section No.72230000 Construction Project No. Milepost 1.860 Station Instructions for Drainage Connection Permit Pursuant to 14-86.004(6), F.A.C. "The Drainage Connection Permit form serves as the application. Once approved by the Department,the form and supporting documents become the Drainage Connection Permit." The applicant shall submit four completed permit packages with original signatures. Each package shall include all required attachments. All required signed and sealed plans and supporting documentation shall be submitted on no larger than (11'.X 17") multipurpose paper, unless larger plan sheets are requested by the reviewer. The package will include the following items. If an item does not apply to your project, indicate"Not Applicable" or"N/A." Included Part Title Completed by: Special Instructions 1 Permit Information Sheet Applicant 2 Certification by a Licensed Licensed Signed and Sealed Professional _ Professional 3 Certification Applicant Signature 4 Owner's Authorization of a Owner Signature Representative 5 Affidavit of Ownership or Owner Signature Control and Statement of Contiguous Interest 6 Permit General Conditions FDOT 7 Permit Special Conditions FDOT 8 As-Built Certification Licensed Signed and Sealed—Submit within 15 Professional working days of completion of construction Attachment Legal Description Attachment Photographs of Existing — — Conditions Attachment Location Map Attachment Grading Plan Attachment Soil Borings Licensed Attachment Water Table/Percolation Professional Signed and Sealed Attachment Calculations Attachment CD with Electronic Files of all Scanned Images in pdf format Submittal Items Note: Different Licensed Professionals may complete parts of the permit package. For example the Licensed Professional signing and sealing the as-built certification may be different from the Licensed Professional who signed and sealed the calculations for the permit package. EXCEPTIONS: Activities that qualify for an Exception are listed in Rule 14-86, F.A.C. A permit application to the Department is NOT required. However, if you desire verification whether the work qualifies for an exception, send a completed copy of this permit package with its requested information to the applicable FDOT District Office. RULE 14-86004,F.A.G STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-C6 DRAINAGE CONNECTION PERMIT ROADWAY DESIGN 10!08 Page 2 o'8 PART 1 —Permit Information Sheet Select one: ® Permit ❑ Exception Pursuant to 14-86.002(2), F.A.C. "Applicant means the owner of the adjacent property or the owner's authorized representative." Applicant Select one: ❑ Property Owner ® Owner's Representative(Complete Part 4) Name: Richard Bushey Title and Company: Managing Member-CDA Holdings, LLC Address: One Columbus Center, Suite 600 City: Virginia Beach State:VA Zip: 23462 Telephone: (757)435-3132 FAX: Email: drbusheydynamiccommercial.com Property Owner(If not applicant) Name: Glenn Plumbs Title and Company: Senior Vice President- Hess Retail Stores LLC Address: 500 Speedway Drive City: Enon State: OH Zip: 45323 Telephone: (937)864-3000 FAX: (937)863-6722 Email: Applicant's Licensed Professional Name: Darren T.R. Eyre, P.E. Florida License Number: 77996 Title and Company: Project Engineer,Thomas Engineering Group Address:4950 W Kennedy Blvd. Suite 600 City:Tampa State: FL Zip: 33609 Telephone: (813)379-4100 FAX: (813)379-4040 Email: deyre@Thomaseg.com Project Information: Project Name: Dollar Tree—Mayport Rd. Location: 2321 Mayport Rd. A1A Atlantic Beach STREET SR NO. US HWY NO. CITY Duval 08 2S 29 E COUNTY SECTION(S) TOWNSHIP(S) RANGE(S) `Geographic Coordinates: Latitude(DMS.SSS): 30°21'00.1" Longitude(DMS.SSS): -81°24'46.6" Horizontal Datum: (NAD 83/ Adj.) •State Plane Coordinates: Northing 525915.158 Easting: 2187463.056 Projection Zone: ❑ Florida North ® Florida East ❑ Florida West Coordinate shall be the center of the driveway intersection with FDOT RNV, or, if there is no driveway connection, near the center of the property line nearest the state highway. "Check with the FDOT Office for requirement. RULE 14-86 004.F A C. STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-06 DRAINAGE CONNECTION PERMIT ROADWAY DESIGN 10/08 Pape 3 of 8 Brief description of facility and proposed connection:This project proposes the construction of a 9,973 SF Dollar Tree including parking and utitlities. Briefly describe why this activity requires a Drainage Connection Permit (Include where the stormwater will discharge to FDOT right of way): This project will require a DCP as the pond is adjacent to the FDOT RNV. III RULE 1456 004 F A C STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040.06 DRAINAGE CONNECTION PERMIT ROADWAY DESIGN 10/08 Page 4 of 8 PART 2—Certification by a Licensed Professional In accordance with Rule 14-86, Florida Administrative Code (F.A.C.), I hereby certify that the following requirements are and/or will be met. This project has been designed in compliance with all applicable water quality design standards as required by state governmental agencies. 14-86.004(3)(f) (F.A.C.): Certification by a Licensed Professional that the complete set of plans and computations complies with one of the following Rules Sections: • 14-86.003(2)(a) (F.A.C.), or ❑ 14-86.003(2)(b) (F.A.C). (check one) I further certify that a National Pollutant Discharge Elimination System (NPDES) permit for stormwater discharges associated with industrial activity from construction sites ❑ is required ® is not required. (check one) I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment. This certification shall remain valid for any subsequent revision or submittal of plans, computation or other project documents by me. Name of Licensed Professional: Darren T.R. Eyre. P.E. Florida License Number: 196 Company Name(if applicable): Thomas Engineering Group Certificate of Authorization Number(if applicable): Address: 4950 W Kennedy Blvd, Suite 600 City: Tampa State: Florida Zip: 33609 Telephone: (813) 379-4100 Fax: (813) 394-2506 Email: deyre( Thomaseg.com ` ti1F�S f?EASOR // T\ • NSF ' Fy i I- .• ... — 1 ; — Signature of L ensed ofessional SEOF • �� • gSP P • ate On•'• FLORVP•' ��� ////‘ 's iSIONP`. `\ (Affix Seal) ��/Iliiiii'\`�� RULE 1486 C04 F A C STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-06 DRAINAGE CONNECTION PERMIT ROADWAY DESIGN 10/08 Page 5 of 8 PART 3-Certification by Applicant I hereby certify that the information in this submittal is complete and accurate to he best of my knowledge. Applicant's Signature: ■ Date: \ Name (Printed): T�^�?�_ Gym_. Title and Company: Managing Member-CDA Holdings, LLC Address: One Columbus Center, Suite 600 Virqina Beach, VA 23462 Phone Number: (757) 435-3132 E-mail address: drbushey andynamiccommercial.com PART 4-Owner's Authorization of a Representative I (we), the owner, , do hereby authorize the following person, or entity, as my representative: Name(Printed): Darren T.R. Eyre. P.E. Title and Company: Thomas Engineering Group Address: 4950 W Kennedy Blvd. Suite 600. Tampa, FL 33609 Phone Number: 813-379-4100 E-mail address: deyre c(DThomaseq.com Part 5-Affidavit of Property Ownership or Control and Statement of Contiguous Interest C- , certify that I own or lawfully control the following described property: See Attached Legal Does the property owner own or have any interests in any adjacent property? No ❑ Yes If yes, please describe. Owner's Signature required for Parts 4 and/or 5 We will not begin on the drainage connection until I receive the Permit and I understand all the conditions of the Permit. When work begins on the connection, I am accepting all conditions listed in the Permit. Name (Printed): Darren T.R. Eyre, P.E. Address: 4950 W Kennedy Blvd. Suite 600. Tampa, FL 33609 Phone Numb 13-379-4100 Signature: k' - c' Date: RULE 14-86.004 FA.0 STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-06 DRAINAGE CONNECTION PERMIT ROADWAY DESIGN 10;08 Page 7 of 8 PART 7—Permit Special Conditions—To be completed by FDOT The above request has been reviewed and has been found to meet the regulations as prescribed in Rule 14-86, F.A.C., and is hereby approved, subject to the following special conditions: (1) A Drainage Connection Permit does not exempt the permittee from meeting all other applicable regulations and ordinances governing stormwater management. (2) All work done in conjunction with the drainage connection permit shall meet and adhere to all general and specific conditions and requirements contained on the Permit. (3) Within 15 working days after completion of the work authorized by an approved Drainage Connection Permit, the permittee shall notify the Department in writing of the completion; and for all design work that originally required cerification by a Licensed Professional, this notification shall contain the As-Built Certification, Part 8 of the Permit. The certification shall state that work has been completed in substantial compliance with the Drainage Connection Permit. (4) The permittee or property owner will be required to reimburse the Department for any fines, penalties and cost, e.g., abatement costs, mitigation costs, remediation costs, etc. incurred by the Department in the event the permittee's discharge fails to meet the applicable water quality standards or minimum design and performance standards contrary to the permittee's assurances provided in subsection 14-86.003(2), F.A.C. Specific Authority 334.044(2), (15) FS. Law Implemented 334.044(15) FS. History-New 11-12-86, Amended 1-20-09. (5) Permit Suspension or Revocation. A permit will be suspended or revoked if: (a)The permitted drainage connection is not constructed, operated, or maintained in accordance with the permit; (b) Emergency conditions or hazards exist; (c) False or misleading information is submitted to the Department in the Drainage Connection Permit package; (d)Another governmental entity revokes or suspends a permit which was the basis upon which a Department Drainage Connection Permit was obtained; (e)The As-Built Certificate required for the Drainage Connection Permit is not submitted in accordance with subsection 14-86.005(3), F.A.C. (f)Any discharge above the permitted design discharge. Department of Transportation: Signature Title Jacksonville Maintenance Engineer Date 3/12/15 RULE 14-86.004,F A C STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-06 DRAINAGE CONNECTION PERMIT ROADWAY DESIGN 10108 Page 6 of 8 PART 6—Permit General Conditions 1. This permit is a license for permissive use only and does not convey any property rights either in real estate or material, or any exclusive privilege and it does not authorize any injury to private property or invasion of private rights, or any infringement of Federal, State or local laws, rules or regulations; nor does it obviate the necessity of obtaining any required state or local approvals. 2. The drainage connection as authorized herein shall be constructed and thereafter maintained in accordance with the documents attached hereto and incorporated by reference herein. All work performed in the Department's right of way shall be done in accordance with the most current Department standards, specifications and the permit provisions. Such construction shall be subject to the inspection and approval of the Department, and the Department may at any time make such inspections as it deems necessary to assure that the drainage connection is in compliance with this permit. 3. The entire expense of construction within the Department right of way, including replacement of existing pavement or other existing features, shall be borne by the permittee. 4. The permittee shall maintain that portion of the drainage connection authorized herein located on permittee's property in good condition. The Department shall maintain that portion of the drainage connection authorized herein located within its right of way. 5. If the drainage connection is not constructed, operated or maintained in accordance with this permit, the permit may be suspended or revoked. In this event modification or removal of any portion of the drainage connection from the Department's right of way shall be at the permittee's expense. 6. The Department reserves the right to modify or remove the drainage connection to prevent damage or in conjunction with road improvements. 7. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the Department's right, title, and interest in the land to be entered upon and used by the permittee, and the permittee will, at all times, assume all risk of and indemnify, defend and save harmless the Department from and against any and all loss, damage, cost or expense arising in any manner on account of the exercise or attempted exercises by said permittee of these rights and privileges, regardless of the respective degrees of fault of the parties. 8. Utilities, including gas lines, may exist within the right of way. Prior to beginning work the permittee shall contact Sunshine State One Call of Florida, Inc at 811 or 800-432-4770, who will notify all utility owners near the scheduled project. The utility owners have two(2)full business days to provide locations of their respective facilities. The permittee shall be solely responsible for any damage to or conflicts with gas lines, utilities and/or third persons. 9. The permittee shall notify the Department of Transportation Maintenance Office located at Jennifer Rhoden, 838 Ellis Road South, Jacksonville, FL 32205 Phone(904) 360-5372 48 hours in advance of starting any work on the drainage connection authorized by this permit and also 24 hours prior to any work within the Department's right of way. Construction of any work on the right of way shall be completed within 60 days after such notification. If such construction is not completed within 60 days after such notification, the permittee shall notify the Department of the anticipated completion date. 10. This permit shall expire if construction on the drainage connection is not begun within one year from the date of approval and if construction on the drainage connection is not completed by(Date) 3/12/16 11. A permittee may request an extension of the Drainage Connection Permit expiration date by filing a written request for a permit time extension. All requests for time extensions must be received by the Department 15 working days prior to the expiration date. 12. All the provisions of this permit shall be binding on any assignee or successor in interest of the permittee. RULE 1486 004.F A C STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-06 DRAINAGE CONNECTION PERMIT ROADWAY DESIGN 1ao6 Page 8 of 8 PART 8—As-Built Certification Within 15 working days of completion of construction, you must send this certification to the Department office in which you filed your DOT Drainage Permit. 1. STORM WATER FACILITY INFORMATION Permit No.: Source (Project) Name: Source Location: Street City: County: Source Owner: Owner Address: 2. AS-BUILT CERTIFICATION I hereby certify that this storm water facility has been built substantially in accordance with the certified design plans, and that any substantial deviations (noted below)will not prevent the facility from functioning in compliance with the requirements of Chapter 14-86 F.A.C. when properly maintained and operated. These determinations have been based upon on-site observation of construction, scheduled and conducted by me or by a project representative under my direct supervision. Name of Licensed Professional: Florida License Number: Company Name (if applicable): Certificate of Authorization Number(if applicable): Address: City: State: Zip: Telephone: Fax: Email: Signature of Licensed Professional Date (Affix Seal) Substantial deviations from the approved plans and specifications(attach additional sheets if required). Rule 14.56.E C. STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-18 DRIVEWAY CONNECTION PERMIT SYSTEMS PLANNING-0808 Page 1 of 3 FOR ALL CATEGORIES PART 1: PERMIT INFORMATION APPLICATION NUMBER: 15-A-294-0003 Permit Category: B Access Classification: 6 Project: Dollar Tree Mayport Road Permittee: CDA Holdings, LLC Section/Mile Post: 72330/1.860-1.861 State Road: A1A/101 Section/Mile Post: State Road: PART 2: PERMITTEE INFORMATION Permittee Name: CDA Holdings, LLC; Richard Bushey Permittee Mailing Address: One Columbus Center, Suite 600 City,State,Zip: Virginia Beach,VA Telephone: (757)435-3132 Engineer/Consultant/or Project Manager: Thomas Engineering Group Engineer responsible for construction inspection: Darren T.R. Eyre, P.E. 77996 NAME P F C Mailing Address: 4950 W.Kennedy Boulevard, Suite 600 City,State,Zip: Tampa, Florida,33609 Telephone: (813)379-4100 FAX,Mobile Phone, etc. PART 3: PERMIT APPROVAL The above application has been reviewed and is hereby approved subject to all Provisions as attached. Permit Number: 15-A-294-0003 Department of Transportation Signature: _l,—f Title: Jacksonville Maintenance Engineer Department Representative's Printed Name Bob Kosoy, P.E. Temporary Permit o YES © NO (If temporary,this permit is only valid for 6 months) Special provisions attached © YES NO Date of Issuance: 11 f 4 If this is a normal(non-temporary)permit it authorizes construction for one year from the date of issuance. This can only be extended by the Department as specified in 14-96.007(6). See following pages for General and Special Provisions Rule 14.86.F.AC. 850040.18 SYSTEMS PLANNING•06/06 Page 2o'3 PART 4: GENERAL PROVISIONS 1. Notify the Department of Transportation Maintenance Office at least 48 hours in advance of starting proposed work. Phone: (904)360-5372 , Attention: Jennifer Rhoden 2. A copy of the approved permit must be displayed in a prominent location in the immediate vicinity of the connection construction. 3. Comply with Rule 14-96.008(1), F.A.C., Disruption of Traffic. 4. Comply with Rule 14-96.008(7), F.A.C., on Utility Notification Requirements. 5. All work performed in the Department's right of way shall be done in accordance with the most current Department standards, specifications and the permit provisions. 6. The permittee shall not commence use of the connection prior to a final inspection and acceptance by the Department. 7. Comply with Rule 14-96.003(3)(a), F.A.C., Cost of Construction. 8. If a Significant Change of the permittee's land use, as defined in Section 335.182, Florida Statutes, occurs,the Permittee must contact the Department. 9. Medians may be added and median openings may be changed by the Department as part of a Construction Project or Safety Project. The provision for a median might change the operation of the connection to be for right turns only. 10. All conditions in NOTICE OF INTENT WILL APPLY unless specifically changed by the Department. 11. All approved connection(s)and turning movements are subject to the Department's continuing authority to modify such connection(s)or turning movements in order to protect safety and traffic operations on the state highway or State Highway System. 12. Transportation Control Features and Devices in the State Right of Way. Transportation control features and devices in the Department's right of way, including, but not limited to, traffic signals, medians, median openings,or any other transportation control features or devices in the state right of way, are operational and safety characteristics of the State Highway and are not means of access. The Department may install, remove or modify any present or future transportation control feature or device in the state right of way to make changes to promote safety in the right of way or efficient traffic operations on the highway. 13. The Permittee for him/herself, his/her heirs, his/her assigns and successors in interest, binds and is bound and obligated to save and hold the State of Florida, and the Department, its agents and employees harmless from any and all damages, claims, expense,or injuries arising out of any act, neglect, or omission by the applicant, his/her heirs, assigns and successors in interest that may occur by reason of this facility design, construction, maintenance, or continuing existence of the connection facility,except that the applicant shall not be liable under this provision for damages arising from the sole negligence of the Department. 14. The Permittee shall be responsible for determining and notify all other users of the right of way. 15. Starting work on the State Right of Way means that I am accepting all conditions on the Permit. R,,:e 14.9€ F C. 850-04018 SYSTEMS PLANNING-06106 Page 3 of 3 PART 5: SPECIAL PROVISIONS NON-CONFORMING CONNECTIONS: 0 YES © NO If this is a non-conforming connection permit,as defined in Rule Chapters 14-96 and 14-97,then the following shall be a part of this permit. 1. The non-conforming connection(s)described in this permit is(are)not permitted for traffic volumes exceeding the Permit Category on page 1 of this permit,or as specified in"other Special Provisions"below. 2. All non-conforming connections will be subject to closure or relocation when reasonable access becomes available in the future. Tt ER SPECIAL PROVISIONS: PART 6: APPEAL PROCEDURES You may petition for an administrative hearing pursuant to sections 120.569 and 120.57,Florida Statutes. If you dispute the facts stated in the foregoing Notice of Intended Department Action(hereinafter Notice),you may petition for a formal administrative hearing pursuant to section 120.57 (1),Florida Statutes. If you agree with the facts stated in the Notice,you may petition for an informal administrative hearing pursuant to section 120.57(2),Florida Statutes. You must file the petition with: Clerk of Agency Proceedings Department of Transportation Haydon Burns Building 605 Suwannee Street,M.S.58 Tallahassee,Florida 32399-0458 The petition for an administrative hearing must conform to the requirements of Rule 28-106.201(2)or Rule 28-106.301(2),Florida Administrative Code,and be filed with the Clerk of Agency Proceedings by 5:00 p.m.no later than 21 days after you received the Notice. The petition must include a copy of the Notice,be legible,on 8 1/2 by 11 inch white paper,and contain: 1. Your name,address,telephone number,any Department of Transportation identifying number on the Notice,if known,the name and identification number of each agency affected,if known,and the name,address,and telephone number of your representative,if any, which shall be the address for service purposes during the course of the proceeding. 2. An explanation of how your substantial interests will be affected by the action described in the Notice; 3. A statement of when and how you received the Notice; 4. A statement of all disputed issues of material fact. If there are none,you must so indicate; 5. A concise statement of the ultimate facts alleged,including the specific facts you contend warrant reversal or modification of the agency's proposed action,as well as an explanation of how the alleged facts relate to the specific rules and statutes you contend require reversal or modification of the agency's proposed action; 6. A statement of the relief sought,stating precisely the desired action you wish the agency to take in respect to the agency's proposed action. If there are disputed issues of material fact a formal hearing will be held,where you may present evidence and argument on all issues involved and conduct cross-examination. If there are no disputed issues of material fact an informal hearing will be held,where you may present evidence or a written statement for consideration by the Department. Mediation,pursuant to section 120.573,Florida Statutes,may be available if agreed to by all parties,and on such terms as may be agreed upon by all parties. The right to an adminstrative hearing is not affected when mediation does not result in a settlement. Your petition for an administrative hearing shall be dismissed if it is not in substantial compliance with the above requirements of Rule 28-106.201(2) or Rule 28-106.301(2),Florida Administrative Code. If you fail to timely file your petition in accordance with the above requirements,you will have waived your right to have the intended action reviewed pursuant to chapter 120,Florida Statutes,and the action set forth in the Notice shall be conclusive and final. Centennial FDOT 915*2015 • Florida Department of Transportation RICK SCOTT 605 Suwannee Street JIM BOXOLD GOVERNOR Tallahassee,FL 32399-0450 SECRETARY March 12,2015 Darren T.R. Eyre,P.E. Thomas Engineering Group 4950 Kennedy Blvd., Suite 600 Tampa, Florida 33609 RE: ROADWAY SECTION NO.: 72230—STATE ROAD A1A/101 PERMIT NO.(s): 15A2940003(DRIVEWAY)and 15D2940004(DRAINAGE) PROJECT: DOLLAR TREE MAYPORT ROAD Dear Mr. Eyre: This will acknowledge your request on behalf of your client, CDA Holdings, LLC to make driveway and drainage modifications on State Road Al A/101 at milepost 1.860 to 1.861 in Duval County. CDA Holdings,LLC is hereby granted permission to modify the existing access as shown on the enclosed approved plan,permits,Florida Department of Transportation(FDOT)specifications,and current Roadway Design Standard Indices. CDA Holdings,LLC approved permit is to adhere to plans signed and sealed February 25,2015. A preconstruction meeting shall be held forty-eight(48)hours prior to the start of any work within Florida Department of Transportation(FDOT)right-of-way and a final inspection shall be conducted ten(10)clays after completion of the project. Notify Jennifer Rhoden, Inspector Coordinator at (904) 360-5372 a minimum of forty-eight(48)hours prior to beginning work. SPECIAL CONDITIONS: CDA Holdings.LLC or designee is to submit a lane closure analysis to the FDOT Inspector prior to closing any lanes.Coordinate all lane closure times with the FDOT Permit Inspector prior to closing any lanes. Engineer Certification required prior to final acceptance of the Drainage Permit work (please reference Page 8 of the Drainage Permit). A copy of the attached approved plan and permit shall be on the job site at all times. Construction on the Department of Transportation right-of-way shall meet all of the Department's standard construction specifications and safety criteria. Before construction is to begin, the applicant shall deliver to the Department proof of insurance verifying that the applicant or the applicant's contractor has coverage under a liability insurance policy issued by an insurance company authorized to do business in the State of Florida naming itself as insured, and the Page 1 of 3 • DRIVEWAY PERMIT 15A2940003 AND DRAINAGE PERMIT 15D2940004 DOLLAR TREE MAYPORT ROAD Department as an additional named insured,which policy shall contain contractual endorsement specifically covering the liabilities arising from the indemnity agreement. A. The policy shall provide public liability insurance, including property damage, in the amount of $500,000 combined single limit for each occurrence. B. The above required policy shall be endorsed with a provision requiring the insurance company to notify the Department 30 days prior to the effective date of cancellation or of any material change in the policy if the change occurs during the construction period. C. The applicant shall pay all premiums and other charges due on said policy and keep said policy,or a materially identical replacement policy, in force to insure the entire period of construction of the connection. All striping within Department of Transportation right-of-way to be Thermoplastic (lead free), six inches in width,and according to Standard Index 17346 and 17352. Permittee shall furnish the Department with manufacturer's certification that the thermoplastic placed during construction is lead free. If any work to be done conflicts with traffic signal poles or loops,then approval must be obtained from the city/county government involved. This permit is issued with the understanding that construction shall be performed in accordance with Department of Transportation specifications by a Department approved contractor and that all cost of construction shall be borne by the applicant. It is also understood and agreed that the rights and privileges herein set out are granted only to the extent of the State'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 State of Florida and Department from and against any and all loss, damage, cost or expense arising in any manner on account of the exercise or attempted exercises by said holder of the aforesaid rights and privileges. During construction, all safety regulations of the Department shall be observed and holder must take measures, including placing and display of safety devices, which may be necessary in order to safely conduct the public through the project area, in accordance with the Federal Manual on Uniform Traffic Control Devices (MUTCD), the Department's Roadway and Traffic Design Standards and Standard Specifications for Road and Bridge Construction. For safety and operational purposes, the Department may require or restrict hours of construction to minimize disruption of traffic on the State Highway System. When construction activity on a connection causes undue disruption of traffic or creates safety hazards on a state highway, the District Secretary or designee shall advise the pennittee of the need for immediate corrective action by a specified time and may issue a stop work order if deemed necessary. Construction shall be completed within one year of the date of issuance of the permit. Failure to comply with the one year time limit shall result in an automatic expiration of the permit unless extended by the Department as described in Section 335.185(2), Florida Statutes. A stop work order may be issued by the Department if work exceeds the imposed time restrictions. For any permit which expires for failure to construct the connection within the one year limit,the applicant shall submit a new application, including the payment of the required application fee prior to the initiation or continuation of any construction. If any trees over 4" in diameter in the right of way of SR Al A/101 are required to be cleared to construct the project,then the permittee will be required to submit a tree survey showing all trees,types,and sizes to be cleared. This survey will be reviewed by the Department and, if deemed necessary,the permittee will Page 2 of 3 • DRIVEWAY PERMIT 15A2940003 AND DRAINAGE PERMIT 15D2940004 DOLLAR TREE MAYPORT ROAD provide a mitigation plan for the trees. NO TREES OVER 4" WILL BE CUT WITHOUT FURTHER PERMISSION FROM THE DEPARTMENT. Failure by the applicant to abide by the permit conditions that are applicable after permit issuance shall be just cause for the Department to order alteration of the connection,or to revoke the permit and close the connection at the expense of the applicant,subject to the provisions in this rule chapter, or for the Department to have the necessary modifications made and seek payment from the applicant. The permit requirements shall be binding on the applicant, the applicant's successors, heir, and assigns,the permit application signatories,and all future owners and occupants of the property. The Department may require permits to be recorded in the public records with the legal description of the property when cross or joint access exists, when permit conditions requiring future performance by the permittee exist such as installation of traffic control features or devices,or when other conditions warrant recording. Sincerely, Bob Kosoy,P.E. Jacksonville Maintenance Engineer (904)360-5222 Bob.Kosoy @dot.state.fl.us SK/rp Enclosures cc: Sean Kelly,P.E.,Jacksonville Assistant Maintenance Engineer Nathan Lee,P.E., District Permits Engineer Jennifer Rhoden, Inspector Coordinator Page 3 of 3 i, ZONING REVIEW COMMENTS -. ,V `J City of Atlantic Beach Building and Zoning Department � 800 Seminole Road Atlantic Beach, Florida 32233-5445 44-4 0.H1>%. Phone: (904) 270-1605 Fax: (904)247-5845 Email: dreeves @coab.us Permit: 15-FNCE-530 Applicant: Bullard Fence Review: 1st Address: 1241 Haines St,Jacksonville, FL 32206 Site Address: 456 Irex Road Phone: (904) 781-2397 RE#: 171425-0000 Email: sean @bullardfence.com Informational Comments 1. Easement: There is a drainage and/or utility easement across the western and northern edges of the property. Repair and/or reconstruction of the fence in this easement needed as a result of work performed by the city, or a representative of, is the responsibility of the property owner. Derek W. Reeves Zoning Technician dreeves @coab.us Clark, Geer, Latham & Associates, Inc. Engineer•Architect 3901 Spring Hill Avenue West•Mobile,Alabama 36608•251/344-7073•FAX 251/343-9179 City of Atlantic Beach Building Permit Division Seminole Road �c Atlantic Beach, FL 32233 Attn: Rey Escanio, Ricky Carper, & Derek Reeves Zg 4 3 Subject: Dollar Tree—Atlantic Beach, FL F L'/ N\N\N/ Date: 2-5-15 /9 Permit#: I4CNEW536 ey To those it may concern, The following is a list of responses to the 2nd submittal comment letter we received. Responses to Fire Marshal Comments received 2-4-15 (Rey Escanio 904-255-8561) rescanio @coj.net 1. Provide design criteria for fire sprinkler system FAC 61615-32. Sheet FP-1.1 has been added to show intent. Responses to Public Works Comments received 1-20-15 (Ricky Carper 904-247-5831) rcarper @coab.us 1. Provide copy of SJRWMD ERP modification application (42-031-37016-1) or new ERP application. Drainage calculations received but need copy of application. Will forward once we have an approved permit. 2. Provide copy of FDOT ROW/Connection Permit to Public Works when received. Need copy of connection permit. Will forward once we have an approved permit. Please feel free to call if you have any questions regarding these responses. Thank you, I Mark M. Aldred, AIA 1 RECEIVED fs y;,;,� City of Atlantic Beach SAN 8 2015 APPLICATION NUMBER s • Building Department (To be assign by the Building Department.) ` 1 800 Seminole Road RR �^/ /1) .„, Atlantic Beach, Florida 3223 '5d "/Y v” -ccSk ;� / Phone(904)247-5826 Fax(904)247 5845 / . cs;��;;/ E-mail: building-dept @coab.us V �� Date routed: I�- City web-site: http://www.coab.us APPLI ATION REVIEW AND TRACKING FORM of Property Address: / 4 ' /A , Ar ■ Department review required Yes No Buil Applicant:. _ 'arming &Zonin Tree ABministrator Project: jb/Jcit —1/;:c i lic Wor Public Utilities Public Safety <----F e Services Review fee $ 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: APPLICATION STATUS Reviewing Department First Review: ['Approved. Denied. (Circle one.) Comments: BUILDING 1 Q , cc-c 4 - PLANNING&ZONING , Reviewed by: `� Date: //19 A TREE ADMIN. Second Review: pproved as revised. ['Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES AO z PUBLIC SAFETY Reviewed by: ���[" / Date: 3 /7;5 FIRE SERVICES Third Review: ❑Approved as revised. Denied. Comments: Reviewed by: Date: Revised 07/27/10 PUBLIC WORKS PLAN REVIEW COMMENTS Date: c 1 3 15 Initials: PN ML Project Name/Address : a3 � Application Permit#: s�� Check Box Check Application Tracking Comments to Add Box to Comment "Print" IMPS Provide table of impervious surface calculations for entire lot (existing and post ❑ ❑ construction). ESCP Provide erosion and sediment control plans with installation details and maintenance ❑ ❑ schedule. DPLN Provide drainage plans showing site topography (flow arrows, etc.) ❑ ❑ RMRO All runoff must remain on-site. Cannot raise lot elevation without measures to retain ❑ ❑ runoff. CSMP Provide construction site management plan, including Right-of-Way Permit if using ❑ ❑ right-of-way for construction parking. TSUR Provide a pre-construction topographic survey prepared by a Florida Licensed Professional ❑ ❑ Land Surveyor, showing 1' contours. Section 24-66(b) of the Land Development Regulations requires on-site storage for LDCS increased run-off if adding 400 SF or more impervious surface. Provide Delta volume ❑ ❑ calculations and on-site retention required per Section 24-66(b). (See attached information sheet.) PCTS If on-site storage is required, a post construction topographic survey documenting proper ❑ ❑ construction will be required. RWPM A Right-of-Way Permit must be obtained for use ❑ ❑ REPM A Revocable Encroachment Permit must be obtained. ❑ ❑ PLWP Pool—Wellpoint (if used) must discharge into vegetated area 10' minimum from street or ❑ ❑ drainage feature (swale, structure or lagoon). All concrete driveway aprons must be 5" thick,4000 psi, with fibermesh from edge of DAPR pavement to the property line. Reinforcing rods or mesh are not allowed in the right-of- ❑ ❑ way. (Commercial driveways—6" thick.) Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be URCT overlaid 10 feet in each direction from the center of the cut. Repair must be shown on the ❑ ❑ plans. RWRS Full right-of-way restoration, including sod, is required. ❑ ❑ Roll off container company must be on City approved list and container cannot be placed on ROFF City right-of-way. (Approved: Advanced Disposal, Realco Recycling, Republic Services, ❑ ❑ Shappel's and Waste Pro). Full erosion control measures must be installed and approved prior to beginning any earth ECIN disturbing activities. Contact Public Works (247-5834)for Erosion and Sediment Control ❑ ❑ Inspection prior to start of construction. MEET Recommend Owner/Contractor meet with Public Works Director to discuss proposed ❑ ❑ construction. Call 247-5834 to make an appointment. ❑ ❑ ❑ ❑ ADDENDUM #3 (SLM REVISION #3) of Plans and Specifications for Dollar Tree—Atlantic Beach, FL CGL Project 1405-137 February 2nd, 2015 Clark, Geer, Latham &Associates, Inc. Mobile, Alabama NOTE: Addendum #3 contains SLM Revision #3 to the specifications & or drawings as listed below. Changes to the above referenced project have been made that include, but are not limited to the following. Reference specifications & or drawings included in this addendum for changes. The plans for the above referenced project shall be amended to include: 1. Drawing U .has been revised and dated 1/30/15. SLM Revision#3 includes the following: A. Showed protected building per fire comment#1. 2. Drawing T_3 has been revised and dated 1/30/15. SLM Revision #3 includes the following: A. Added fire sprinkler per fire comment#1. 3. Drawing C-9.0 has been revised and dated 1/30/15. SLM Revision#3 includes the following: A. Added fire line & hydrant per fire comment#1. 4. Drawing S-2.0 has been revised and dated 1/30/15. SLM Revision#3 includes the following: A. Raised center bay of side parapets per zoning comment#1. 0 5. Drawing S-3.0 has been revised and dated 1/30/15. SLM Revision#3 includes the following: A. Raised T.O parapet in section F per zoning comment#1. 6. Drawing A-1.0 has been revised and dated 1/30/15. SLM Revision#3 includes the following: A. Added fire sprinkler per fire comment#1. 7. Drawing A-1.1 has been revised and dated 1/30/15. SLM Revision#3 includes the following: A. Added fire sprinkler per fire comment#1. B. Relocated mop sink per changes related to new fire sprinkler per fire comment#1. Page 1 of 3 ti ADDENDUM #3 (SLM REVISION #3) of Plans and Specifications for Dollar Tree—Atlantic Beach, FL CGL Project 1405-137 February 2nd, 2015 Clark, Geer, Latham & Associates, Inc. Mobile, Alabama 16. Drawing MP-3.1 has been revised and dated 1/30/15. SLM Revision#3 includes the following: A. Added sprinkler riser diagram & sprinkler intent notes per fire comment#1. 17. Drawing E-1.1 has been revised and dated 1/30/15. SLM Revision#3 includes the following: A. Revised background fire comment#1. 18. Drawing E-1.2 has been revised and dated 1/30/15. SLM Revision#3 includes the following: A. Added fire alarm criteria per fire comment#2. Addendum #3 was distributed February 2, 2015 End of Addendum#3 Page 3 of 3 Clark, Geer, Latham & Associates, Inc. Engineer•Architect 3901 Spring Hill Avenue West•Mobile,Alabama 36608•251/344-7073•FAX 251/343-9179 City of Atlantic Beach Building Permit Division 800 Seminole Road Atlantic Beach, FL 32233 Attn: Rey Escanio, Ricky Carper, & Derek Reeves Subject: Dollar Tree—Atlantic Beach, FL Date: 1-30-15 Permit#: 14CNEW536 To those it may concern, The following is a list of responses to the 2nd submittal comment letter we received. Responses to Fire Marshal Comments received 1-8-15 (Rev Escanio 904-255-8561) rescanio( coj.net 1. Please provide proof of meeting minimum required fire flow requirements for proposed building per NFPA 1 18.4 and Table 18.4.5.1.2. This can be accomplished by contacting JEA and obtain hydrant flow test information conducted within the last 12 months and providing report with next submission. Flow data can also be obtained by private provider as long as it is witnessed by our office. See attached flow test results. We have revised to include a sprinkler system as required by NFPA Table 18.4.5.1.2 for a flow of less than 2250. 2. Provide the fire alarm design criteria per FAC 61G15-32.008(a-o). Your plans will not be approved without the fire alarm design criteria. We are not asking for shop drawings at this time,just answers to the criteria presented in the A-0. The fire alarm design on sheet E-1.2 has been revised to address the criteria from FAC 61 G 1.5-32.008(a-o) Responses to Public Works Comments received 1-20-15 (Ricky Carper 904-247-5831) rcarper@,coab.us 1. Provide copy of SJRWMD ERP modification application (42-031-37016-1) or new ERP application. Drainage calculations received but need copy of application. Will forward once we have an approved permit. 2. Provide copy of FDOT ROW/Connection Permit to Public Works when received. Need copy of connection permit. Will forward once we have an approved permit. 1 Clark, Geer, Latham & Associates, Inc. Engineer•Architect 3901 Spring Hill Avenue West•Mobile,Alabama 36608•251/344-7073•FAX 251/343-9179 Responses to Zoning Comments received 1-20-15 (Derek Reeves 904-270-1605) dreeves@coab.us 1. Commercial Corridor Design Standards (Section 24-171): The exterior roof design does not meet the requirement for a roof that does not have the appearance of being flat. Please revise plans so that the roof has the appearance of a gable, hip, mansard or other design. Drawings have been revised as requested at the 1-20-15 variance meeting. Please feel free to call if you have any questions regarding these responses. Thank you, V t Mark M. Aldred, AIA 2 r11...14 „ ;r1 J.,. r V January 12, 2015 • Mr. Darren Eyre, P.E. Thomas Engineering RE: Fire Flow Test for Dollar Tree - 2321 Mayport Rd. Dear Mr. Loretta: Per your request, the City flow tested the above fire hydrant with the following results: Location: 2389 Mayport Rd. Tested by: Chris Walker, Division Director Test Date: 1/12/15 Test Time: 9:46 AM Port Diameter: 2.5-inch port Static Pressure: 42 psi Residual Pressure: 35 psi Test Flow Rate: 1,000 gpm The following computational results based on the above variables and NFPA section 291 (2002 edition) are as follows: 1/12/15 - Estimated flow at 20 psi: 1,856 gpm Should you need additional information, please call me at (904) 270-2535 or email me at dkaluzniak(4coab.us. Sincerely, Donna Kaluzniak Utility Director cc: Chris Walker, Division Director Public Utilities Department 1200 Sandpiper Lane Atlantic Beach, FL 32233 (904) 247-5834 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach,,11,32233 Office(904)247-5826 Fax(904)247-5845 Job Address:2321 MAYPORT ROAD ATLANTIC BEACH, FL 32233Permit Number: Legal Description SEE BOTTOM OF SHEET&ALTA SURVEY Parcel# 169398-0410 Floor Area of Sq.Ft. Sq.Ft Valuation of Work$950,000 Proposed Work heated/cooled 9,973 non-heated/cooled 0 Class of Work(circle one): ® Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structurc(s)(circle one): ommercia Residential If an existing structure,is a fire sprinkler system installe s. ire e one): Yes No MO Florida Product Approval# For multiple products use product approval torn Describe in detail the type of work to be performed: NEW BUILDING INCLUDING SITE.STRUCTURAL. ARCHITECTURAL AND INTERIOR,MECHANICAL, PLUMBING AND ELECTRICAL. CONTRACT PROPERTY OWNER: ronerty owner Information: Name: CDA HOLDINGS,LLC Address:C/O DYNAMIC COMMERCIAL -1 COMMERCIAL CENTER City VIRGINIA BEACH State VAZip 23462 Phone 757-333-7504 . E-Mail or Fax#(Optional)drbushey@dynamiccommercial.com Contractor Information: Company Name:TBD-BIDDING Qualifying Agent: Address: City State Zip Office Phone Job Site/Contact Number Fax# State Certification/Registration# Architect Name&Phone# MARK M.ALDRED,AIA 251-344-7073 maldred @cglengineers.com Engineer's Name&Phone# DARREN THOMAS REASOR EYRE, P.E. 813-379-4100 deyre @thomaseg.com Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify'that no work or installation has commenced prior to the issuance of a permit and that all work will be peOonned to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6f months,or if construction or work is suspended or abandoned for a period of six(6)months at any tune after work is commenced /understand that separate permits must be secured for ElectricalWork,Plumbing,Signs,(Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I hereby certify that 1 have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,state,or local law regulating construction or the performance of construction. Signature of Own ' ' ' ' " —.-__.... Signature of Contractor Print Name D.RICHARD BUSHEY-MANAGING MEMBER Print Name Sworn to 4g subscri, d`bretore me ,',N%I11/1//j Sworn to and subscribed before me this ,Day ., �N 11 l> - •A YyI I :.s this _Day of ,20 Notary 'IC lic In . /do i C244,9,„Mr Notary Public LEGAL DESCRIPTION: Z Nj ON ,;(3 Revised 01.26.10 A PORTION OF GOVERNMENT LOT 7,S C ei•8,Taft&OUT'',c:N 29 EAST,DUVAL COUNTY,FLORIDA,BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS:FOR A POINT OF REFER➢tl -,QMMENC HE NO-•''h T CORNER OF FAIRWAY VILLAS AS RECORDED IN PLAT BOOK 39,PAGES 22 AND 22A OF THE CURRENT PUBLIC REC I- OM COUNTY;•♦- • 01°42'10',V,ALONG THE EASTERLY RIGHT-OF-WAY LINE OF MAYPORT ROAD (STATE ROAD A1A,A 100.00 FOOT RIGHT `' Si'A 1 0g ET TO THE POINT OF BEGINNING;THENCE CONTINUE ALONG SAID EASTERLY RIGHT-OF-WAY LINE NO1•42'101N,A DISTAII SJOF F' a A[1JT SITUATE ON SAID EASTERLY RIGHT-OF-WAY LINE; THENCE N88•1T50'E,300.00 FEET; THENCE S01•42'10•E 270.00 FEET;THEt1Gfi�8° 0 A FEET TO THE POINT OF BEGINNING. 1111///` TOGETHER WITH THE EASEMENT RIGHTS GRANTED TO GRANTOR IN INSTRUMENT RECORDED AT OFFICIAL RECORDS VOLUME 6411.PAGE 148.CURRENT PUBLIC RECORDS OF DUVAL COUNTY,FLORIDA Form 62-330.060(1) JOINT APPLICATION FOR INDIVIDUAL AND CONCEPTUAL ENVIRONMENTAL RESOURCE PERMIT/ AUTHORIZATION TO USE STATE-OWNED SUBMERGED LANDS/ FEDERAL DREDGE AND FILL PERMIT FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION/ WATER MANAGEMENT DISTRICTS/ U.S. ARMY CORPS OF ENGINEERS Effective October 1, 2013 i T� 9 U � .O 11111111111111.1111111.111, 4'.1•V ! VWESi F� - 'IV tits Amy Core ' -of Engineers4: INSTRUCTIONS FOR USE OF THIS FORM: This form is designed to assist you in submitting a complete application. All applications must include Section A- General Information for All Activities. Sections B through H list typical information that is needed based on the proposed activities, and are only required as applicable. Part 1-C of Section A will guide you to the correct sections needed based on your proposed activities. Applicants are advised to consult Chapter 62-330. F.A.C., and the Environmental Resource Permit Applicant's Handbook Volumes I and II for information regarding the ERP permitting process and requirements while preparing their application. Internet addresses for Chapter 62-330, F.A.C. and the Applicant's Handbook, Agency contact information, and additional instructions for this form can be found in Attachment 1. What Sections of the Application Must I Fill Out? Section D w 9 9 m 7 9 2 v -ncn gv' ) * < (n0 con cnmcCn 1 cn (� cog ,. Does the project involve.... o m a' cfl m iv o m '.8. C.) 5 m g a i m x ca m 3 n N y o a n O E. cQ 3 cn m O N °' y d m , m c 3 m — Vl O a 7r 9i (Q O O S y y N N N cD = O fD S. M o- f2. Fill in wetlands or waters for a X X single family residence? ■ Docks, shoreline stabilization, X, if seawalls associated with a single X X applicable family residence? Wetland impacts (other than associated with an X X individual residence)? Boating facilities, a marina,jetty, X if reef, or dredging? X X X applicable Any work on state owned X X X submerged land? Construction of a stormwater X, if X management system? applicable Constructing a mitigation bank? X X X, if X applicable Creating a mine? X X' if X applicable Note- if you are required to provide Section B, then you do not have to provide any other Sections, unless the activities are on state-owned submerged lands. In that case, Section F will also be required. If you have any questions, or would like assistance completing this form, please contact the staff of the nearest office of either the Florida Department of Environmental Protection (DEP) or a Water Management District (WMD) (see Attachment 2). Form 62-330.060(1)-Joint Application for Individual and Conceptual Environmental Resource Permit/ Authorization to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1). F.A.C. (10-1-2013) Section A, Page 2 of 9 0 Section A: General Information for All Activities PART 1: NAME, APPLICATION TYPE, LOCATION, AND DESCRIPTION OF ACTIVITY A. Name of project, including phase if applicable: Dollar Tree-Atlantic Beach B. This is for(check all that apply): Construction or operation of new works, activities and/or a stormwater management system ❑ Conceptual Approval of proposed works, activities and/or a stormwater management system ❑ Modification or Alteration of existing works activities and /or a stormwater management system. Provide the existing DEP or WMD permit #, if known: Note: Minor modifications do not require completion of this form, and may instead be requested by letter. ❑ Maintenance or repair of works, activities and/ or stormwater management system previously permitted by the DEP or WMD Provide existing permit#, if known: ❑ Abandonment or removal of works, activities and/or stormwater management system Provide existing DEP or WMD permit#, if known: ❑ Operation of an existing unpermitted stormwater management system. ❑ Construction of additional phases of a permitted work, activity and/ or stormwater management system. Provide the existing DEP or WMD permit#, if known: C. List the type of activities proposed. Check all that apply, and provide the supplemental information requested in each of the referenced application sections. Please also reference Applicant's Handbooks I and II for the type of information that may be needed. ❑ Activities associated with one single-family residence, duplex, triplex, or quadruplex that do not qualify for an exemption or a General Permit: Provide the information requested in Section B. Do not complete Section C. ❑ Activities within wetlands or surface waters, or within 25 feet of a wetland or surface water. (not including the activities associated with an individual residence). Examples include dredging, filling, outfall structures, docks, piers, over-water structures, shoreline stabilization, mitigation, reclamation, restoration/enhancement. Provide the information requested in Section C. ❑ Activities within navigable or flowing surface waters such as a multi-slip dock or marina, dry storage facility, dredging, bridge, breakwaters, reefs, or other offshore structures: In addition to Section C, also provide the information requested in Section D. ❑ Activities that are (or may be) located within, on or over state-owned submerged lands (See Chapter 18-21, F.A.C. https://www.flrules.org/gateway/ChapterHome.asp?Chapter=18-21): In addition to Section B or C, also provide the information requested in Section F Form 62-330.060(1)-Joint Application for Individual and Conceptual Environmental Resource Permit/ Authorization to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1),F.A.C.(10-1-2013) Section A.Page 3 of 9 Construction or alteration of a stormwater management system serving residential, commercial, transportation, industrial, agricultural, or other land uses, or a solid waste facility (excluding mines that are regulated by DEP). Provide the information requested in Section E. ❑ Creation or modification of Mitigation Bank (refer to Chapter 62-342, F.A.C. https://www.flrules.org/gateway/ChapterHome.asp?Chapter=62-342): Provide the information requested in Section G. ❑ Mines (as defined in Section 2.0 of Applicant's Handbook Volume I) that are regulated by the DEP: Provide the information requested in Section H. ❑ Other, describe: Please contact the Agency to determine which additional sections of the application are need. See Attachment 1 for Agency contacts. D. Describe in general terms the proposed project, system, works, or other activities. For permit modifications, please briefly describe the changes requested to the permit: Development of 9,973 SF Discount Retail Building E. For activities in, on, or over wetlands or other surface waters, check the type of federal dredge and fill permit requested (if known): ❑Individual ❑Programmatic General permit#: ❑General ❑Nationwide permit#: ONot Applicable ❑Not sure F. Project/Activity Street/Road Address or other location (if applicable): 2321 Mayport Rd. City: Atlantic Beach County(ies): Duval Zip: 32233 Note: For utility, road, or ditch/canal activities, provide a starting and ending point using street names and nearest house numbers or provide length of project in miles along named streets or highways. G. Project location map and Section. Township, and Range information (use additional sheets if needed): Please attach a location map showing the location and boundaries of the proposed activity in relation to major intersections or other landmarks. The map should also contain a north arrow and a graphic scale; show Section(s), Township(s), and Range(s); and must be of sufficient detail to allow a person unfamiliar with the site to find it. Section(s): 08 Township: 02 Range: 29 Land Grant name, if applicable: Section(s): Township: Range: Section(s): Township: Range: H. Latitude(DMS) 30 ° 21 0.30 " Longitude (DMS) 81 ° 24 46.50 " (Taken from central location of the activity). Explain source for obtaining latitude and longitude (i.e. U.S.G.S. Quadrangle Map, GPS, online resource): google map Tax Parcel Identification Number(s): 169398-0410 [Number may be obtained from property tax bill or from the county property appraiser's office; if on multiple parcels. provide multiple Tax Parcel Identification Numbers] J. Directions to Site (from major roads; include distances and landmarks as applicable): See Location Map K. Project area or phase area: 1.86 acres Form 62-330.060(1)-Joint Application for Individual and Conceptual Environmental Resource PermiU Authorization to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1),F.A.C.(10-1-2013) Section A. Page 4 of 9 L. Name of waterbody(ies) (if known) in which activities will occur or into which the system will discharge: Alligator Creek The following questions (M-O) are not applicable to activities related to a single-family residence, including private single-family residential docks,piers, seawalls or boat ramps. M. Is it part of a larger plan of development or sale? U yes IT no N. Impervious or semi-impervious area excluding wetlands and other surface waters (if applicable): 1.04 acres or square feet 0. Volume of water the system is capable of impounding (if applicable): .272 acre-feet. PART 2: SUPPLEMENTAL INFORMATION, AND PERMIT HISTORY A. Is this an application to modify an existing Environmental Resource Permit, or to construct or implement part of a multi-phase project, such as a project with a Conceptual Approval permit? 1 Yes n No If you answered "yes' please provide permit numbers below: AGENCY DATE PERMIT/APPLICATION NO. PROJECT NAME B. Indicate if there have been any pre-application meeting(s) or other discussions about the proposed project, system or activity. If so. please provide the date(s). location(s) of the meeting. and the name(s) of Agency staff that attended the meeting(s): AGENCY DATE LOCATION MEETING ATTENDEES C. Attach a depiction (plan and section views), which clearly shows the works or other activities proposed to be constructed. Use multiple sheets, if necessary, a scale sufficient to show the location and type of works, and include a north arrow and a key to any symbols used. Specific information to be included in the plans is based on the activities proposed and is further described in Sections B-H. However, supplemental information may be required based on the specific circumstances or location of the proposed works or other activities. D. Processing Fee: Please submit the application processing fee along with this application form and supplemental information. Processing fees vary based on the size of the activity, the type of permit applied for, and the reviewing Agency. Please reference Attachment 3 to determine the appropriate fee. Form 62-330.060(1)-Joint Application for Individual and Conceptual Environmental Resource Permit/ Authorization to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1), F.A.C.(10-1-2013) Section A.Page 5 of 9 PART 3: APPLICANT AND ASSOCIATED PARTIES INFORMATION Instructions: Permits are only issued to entities having sufficient real property interest as described in Section 4.2.3 (d) of Applicant's Handbook Volume I. Please attach evidence of sufficient real property interest over the land upon which the activities subject to the application will be conducted, including mitigation (if applicable). Refer to Section 4.2.3 (d) for acceptable ownership or real property interest documentation. For corporations, list a person who is a registered agent or officer of the corporation who has the legal authority to bind the corporation. A. APPLICANT(ENTITY MUST HAVE SUFFICIENT REAL PROPERTY INTEREST) ❑ THIS IS A CONTACT PERSON FOR ADDITIONAL INFORMATION Name: Last: Bushey First: Richard Middle: Title: Managing Member Company:CDA Holdings, LLC Address:One Columbus Center, Suite 600 City:Virginia Beach State: VA Zip:23462 Home Telephone:(757)435-3132 Work Telephone: Cell Phone: Fax: E-mail Address: drbushey @dynamiccommercial.com Correspondence will be sent via email. Check here to receive correspondence via US Mail: ❑ B. LAND OWNER(S) (IF DIFFERENT OR IN ADDITION TO APPLICANT) ❑ CHECK HERE IF LAND OWNER IS ALSO A CO-APPLICANT Name: Last: Plumby First: Glenn Middle: Title: Senior Vice President Company:Hess Retail Stores LLC Address: 500 Speedway Drive City: Enon State:OH Zip: 45323 Home Telephone:(937) 864-3000 Work Telephone: Cell Phone: Fax: (937) 863-6722 E-mail Address: Correspondence will be sent via email. Check here to receive correspondence via US Mail: ❑ C. OPERATION AND MAINTENANCE ENTITY (see Applicant's Handbook I, Section 12.3) Entity Name: Contact: Last: First: Middle: Title: Company: Address: City: State: Zip: Home Telephone: Work Telephone: Cell Phone: Fax: E-mail Address: Correspondence will be sent via email. Check here to receive correspondence via US Mail: ❑ Form 62-330.060(1)-Joint Application for Individual and Conceptual Environmental Resource Permit/ Authorization to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1),F.A.C.(10-1-2013) Section A, Page 6 of 9 D. CO-APPLICANT (IF DIFFERENT OR IN ADDITION TO APPLICANT AND OWNER) Name: Last: First: Middle: Title: Company: Address: City: State: Zip: Home Telephone: Work Telephone: Cell Phone: Fax: E-mail Address: Correspondence will be sent via email. Check here to receive correspondence via US Mail: ❑ E.ENGINEERING CONSULTANT 0 THIS IS A CONTACT PERSON FOR ADDITIONAL INFORMATION Name: Last: Eyre First: Darren Middle: T.R. Title. Project Manager Company. Thomas Engineering Group, LLC Address: 4950 W. Kennedy Blvd., Suite 600 City: Tampa State: FL Zip: 33609 Home Telephone: Work Telephone: (813)379-4100 Cell Phone: Fax: (813) 379-4040 E-mail Address: deyre @Thomaseg.com Correspondence will be sent via email. Check here to receive correspondence via US Mail: ❑ F. ENVIRONMENTAL CONSULTANT ❑ THIS IS A CONTACT PERSON FOR ADDITIONAL INFORMATION Name: Last: First: Middle: Title: Company: Address: City: State: Zip: Home Telephone: Work Telephone: Cell Phone: Fax: E-mail Address: Correspondence will be sent via email. Check here to receive correspondence via US Mail: ❑ G. AGENT AUTHORIZED TO SECURE PERMIT (IF DIFFERENT FROM CONSULTANT) ❑ THIS IS A CONTACT PERSON FOR ADDITIONAL INFORMATION Name: Last: First: I Middle: Title: Company: Address: City: State: Zip: Home Telephone: Work Telephone: Cell Phone: Fax: E-mail Address: Correspondence will be sent via email. Check here to receive correspondence via US Mail: ❑ Form 62-330.060(1)-Joint Application for Individual and Conceptual Environmental Resource Permit/ Authorization to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1),F.A.C.(10-1-2013) Section A. Page 7 of 9 If necessary, please add additional pages for other contacts and property owners related to this project. PART 4: SIGNATURES AND AUTHORIZATION TO ACCESS PROPERTY Instructions: For multiple applicants please provide a separate Part 4 for each applicant. For corporations, the application must be signed by a person authorized to bind the corporation. A person who has sufficient real property interest (see Section 4.2.3 (d) of Applicant's Handbook Volume I) is required in (B)to authorize access to the property, except when the applicant has the power of eminent domain. A. By signing this application form, I am applying for the permit and any proprietary authorizations identified above, according to the supporting data and other incidental information filed with this application. I am familiar with the information contained in this application and represent that such information is true, complete and accurate. I understand this is an application and not a permit, and that work prior to approval is a violation. I understand that this application and any permit issued or proprietary authorization issued pursuant thereto, does not relieve of any obligation for obtaining any other required federal, state, water management district or local permit prior to commencement of construction. I agree to operate and maintain the permitted system unless the permitting agency authorizes transfer of the permit to a different responsible operation and maintenance entity. I understand that knowingly making any false statement or representation in this application is a violation of Section 373.430, F.S. and 18 U.S.C. Section 1001. Typed/Printed Name of Applicant or Signature of Applicant or Applicant's Date Applicant's Authorized Agent Authorized Agent (Corporate Title if applicable) B. CERTIFICATION OF SUFFICIENT REAL PROPERTY INTEREST AND AUTHORIZATION FOR STAFF TO ACCESS THE PROPERTY: I certify that: ❑ I possess sufficient real property interest in or control, as defined in Section 4.2.3 (d) of Applicant's Handbook Volume I, over the land upon which the activities described in this application are proposed and I have legal authority to grant permission to access those lands. I hereby grant permission. evidenced by my signature below, for staff of the Agency and the U.S. Army Corps of Engineers to access, inspect, and sample the lands and waters of the property as necessary for the review of the proposed works and other activities specified in this application. I authorize these agents or personnel to enter the property as many times as may be necessary to make such review, inspection, and/ or sampling. Further, I agree to provide entry to the project site for such agents or personnel to monitor and inspect permitted work if a permit is granted. OR ❑ I represent an entity having the power of eminent domain and condemnation authority, and I/we shall make appropriate arrangements to enable staff of the Agency and the U.S. Army Corps of Engineers to access, inspect, and sample the property as described above. I I Typed/Printed Name Signature Date (Corporate Title if applicable) Form 62-330.060(1)-Joint Application for Individual and Conceptual Environmental Resource Permit/ Authorization to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1),F.A.C.(10-1-2013) Section A. Page 8 of 9 C. DESIGNATION OF AUTHORIZED AGENT (IF APPLICABLE): I hereby designate and authorize to act on my behalf, or on behalf of my corporation. as the agent in the processing of this application for the permit and/or proprietary authorization indicated above; and to furnish, on request. supplemental information in support of the application. In addition, I authorize the above-listed agent to bind me, or my corporation, to perform any requirements which may be necessary to procure the permit or authorization indicated above. I understand that knowingly making any false statement or representation in thisapplication is a violation of Section 373.430, F.S. and 18 U.S.C. Section 1001. Typed/Printed Name of Applicant Signature of Applicant Date (Corporate Title if applicable) Form 62-330.060(1)-Joint Application for Individual Environmental Resource Permit/Authorization to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1).F.A.C. (10-1-2013) Section A.Page 9 of 9 SECTION E: SUPPLEMENTAL INFORMATION REQUIRED FOR WORKS OR OTHER ACTIVITIES INVOLVING A STORMWATER MANAGEMENT SYSTEM (OTHER THAN A SINGLE-FAMILY PROJECT) Instructions: The information listed in the checklists below represents the level of information that is usually required to evaluate an application. Information can be provided within reports, plans and documents. The level of information required for a specific project will vary depending on the nature and location of the site and the activity proposed. Conceptual approvals generally do not require the same level of detail as a construction permit. However, providing a greater level of detail will reduce the need to submit additional information at a later date. If an item does not apply to your project, proceed to the next item. The supplemental information required by this section is in addition to the information required by Section A of the ERP application. PART 1: STORMWATER MANAGEMENT SYSTEM SUMMARY Provide drainage calculations, signed and sealed by an appropriate registered professional, and supporting documentation demonstrating that the proposed project meets the conditions for issuance under 62-330.301(1)(a),(b),(c),(e), F.A.C. The drainage calculations should include, but not necessarily be limited to, the following: 1. General Site Information: a. 0 Provide pre-development and post-development drainage map(s), as appropriate, that include drainage patterns and basin boundaries with acreage served by each hydraulically separate system, showing the direction of flows, including any off-site runoff being routed through or around the system; topographic information; and connections between wetlands and other surface waters. See Construction Plans b. ❑ Provide the results of any percolation tests, where appropriate, and soil borings that are representative of the actual site conditions. Identify the wet season high water table elevations, soil profiles, and hydraulic conductivity. Include dates, datum, and methods used to determine these soil parameters. N/A c. SI Identify the onsite hydrologic soil classification (e.g. Type A, B/D, D). Reference the source, such as the USDA/NRCS Soil Survey, used in estimating the onsite hydrologic soil classification. Provide maps, as appropriate, with the project limits delineated. See Geotechnical report d. SI Identify the seasonal high water or mean high tide elevation for receiving waters/wetlands into which runoff will be discharged. Include dates, datum, and methods used to determine these elevations. e. SI Identify the name of each receiving waterbody to which the proposed stormwater management system will discharge: Alligator Creek f. IS Indicate the existing land use and land cover. g. 0 Provide the acreage, and percentages of the total project, of the following: 1. Impervious surfaces, excluding buildings, wetlands and other surface waters; 2. Buildings; Aro noi6A 110.fe: (1,-,1,1511:111-) F �� US Army Carps 4,_ of EnglnimS. Form 62-330.060(1)-Joint Application for Individual and Conceptual Environmental Resource Permit/Authonzation to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1), F.A.C.(October 1,2013) Section E.Page 1 of 6 3. Pervious surfaces (green areas not including wetlands); 4. Lakes, canals, retention areas, other open water areas; and 5. Wetlands (Please refer to Section C to ensure consistency in wetland acreages). h. El Provide the location and description of any nearby existing offsite features (such as wetland and other surface waters, stormwater management ponds, and building or other structures) which might be affected by or affect the proposed construction or development. 2. Water Quality Analysis: a. SI Provide a description of the proposed stormwater treatment methodology that addresses the type of treatment, pollution abatement volumes, and recovery analysis. See Stormwater Report b. Is the receiving waterbody known to be impaired, and/or has an established Total Maximum Daily Load (TMDL) or Basin Management Action Plan (BMAP)? If so, please provide specific descriptions of all water quality parameters for which the waterbody is known to be impaired? For more information about water quality, impaired waters, and to determine whether a TMDL has been adopted in your project area, refer to: http://waterwebprod.dep.state.fl.us/basin411/downloads/Florida-Adopted-TMDLs.pdf. To determine whether a BMAP exists, or is being developed in your project area, refer to: http://www.dep.state.fl.us/water/watersheds/bmap.htmfirad. ❑ yes VI no ❑ don't know If yes, provide calculations demonstrating that the proposed project will not contribute to violations of state water quality standards in accordance with the applicable Applicant's Handbook, Vol. II. N/A c. al Does the project have a direct discharge to a Class I, Class II, Outstanding Florida Waters or Class III waters, which are approved, conditionally approved, restricted, or conditionally restricted for shellfish harvesting? To determine whether your project is within, or will discharge to an OFW, or for more information about OFWs in general, refer to: http://www.dep.state.fl.us/water/wassp/ofw.htm. ❑ yes 21 no ❑ don't know If yes, additional treatment in accordance with the applicable Applicant's Handbook, Vol. II, may be required. N/A d. al Provide construction plans and calculations that address the required treatment volume and recovery, as well as stage-storage and design elevations, which demonstrate compliance with the appropriate water quality treatment criteria in the applicable Applicant's Handbook, Vol. II. Provide a description of the engineering methodology, assumptions and references for the parameters listed above, and a copy of all such computations, engineering plans, and specifications used to analyze the system. If a computer program is used for the analysis, provide the name of the program, a description of the program, input and output data, and justification for model selection. 3. Water Quantity Analysis: Provide calculations and documentations demonstrating that the project, as proposed, meets the applicable design criteria as indicated in the applicable Applicant's Handbook, Vol. II. Typically, the information would include, at a minimum, but is not necessarily be limited to, the following: Form 62-330.060(1)-Joint Application for Individual and Conceptual Environmental Resource Permit/Authorization to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1),F.A.C.(October 1,2013) Section E, Page 2 of 6 a. El For projects requiring pre-development analysis, provide an analysis of the pre-development peak rate of discharge and /or volume of runoff, for all design storm events. Account for all onsite depressional storage and offsite contributing area. Please refer to the applicable Applicant's Handbook,Vol. II for the design storm event(s)that apply to your project. N/A b. ❑ Provide an analysis of the post-development peak rate of discharge and/or volume of runoff for all applicable design storm events. Account for all onsite storage and offsite contributing area. Please refer to the applicable Applicant's Handbook, Vol. II for the design storm event(s)and criteria that apply to your project. N/A These analyses should include: El Runoff characteristics, including area, runoff curve number or runoff coefficient, and time of concentration for each drainage basins in the pre-development and post-development condition; El Design storms used including rainfall depth, duration, frequency, and distribution; ❑ Runoff hydrograph(s)for each drainage basin,for all required design storm event(s); ❑ Stage-storage computations for any area such as a reservoir, closed basin, detention area, or channel, used in storage routing; ❑ Stage-discharge computations for any storage areas at a selected control point, such as control structure or natural restriction; ❑ Flood routings through on-site conveyance and storage areas; ❑ Water surface profiles in the primary drainage system for each required design storm event(s); ❑ Runoff peak rates and volumes discharged from the site for each required design storm event(s); El Design tailwater elevation(s) for each storm event at all points of discharge (include source or method of estimate); and ❑ Pump specifications and operating curves for range of possible operating conditions (if used in system). Provide a description of the engineering methodology, assumptions and references for the parameters listed above, and a copy of all such computations, engineering plans, and specifications used to analyze the system. If a computer program is used for the analysis, provide the name of the program, input and output data,justification for model selection, and, if necessary, a description of the program. N/A 4. Floodplain Analysis(where applicable). N/A a. ❑ If the project is in a known floodplain of a stream or other water course, identify the appropriate floodplain boundary and approximate flooding elevations of any lake, stream or other watercourse located on or adjacent to the site. b. ❑ For traversing works, in accordance with the applicable Applicant's Handbook, Vol. II, provide: Form 62-330.060(1)-Joint Application for Individual and Conceptual Environmental Resource Permit/Authorization to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1),F.A.C.(October 1,2013) Section E,Page 3 of 6 ❑ Hydraulic calculations for all proposed traversing works; and ❑ Water surface profiles showing upstream impact of traversing works. c. ❑ For impacts to regulated floodplains, in accordance with the applicable Applicant's Handbook, Vol. II, provide: ❑ Location and volume of encroachment within regulated floodplain(s); and ❑ Plans and calculations for compensating floodplain storage, if necessary, and calculations required for determining minimum building and road flood elevations. PART 2: CONSTRUCTION PLANS See Construction Plans 1. Provide clear, construction level detailed plans for the system. The plans must be signed and sealed by an appropriate registered professional as required by law. These plans should include cumulative information from all applicable sections; as well as the following: a. 0 Project area boundary and total area, including distances and orientation from roads or other landmark. b. 0. Existing topography extending at least 100 feet off the project area. All topography shall include location and description of benchmarks, reference to NGVD 1929 or NAVD 1988 along with the conversion factor. c. ❑ Proposed site plan with acreage, including the following: ❑ plan view of proposed development, including impervious surfaces and water management areas; LI land cover and natural communities*; ❑ wetlands and other surface waters*; ❑ undisturbed uplands*; ❑ aquatic communities*; ❑ proposed buffers*; ❑ proposed impacts to wetlands and other surface waters, and any proposed connections/outfalls to other surface waters or wetlands, (if applicable); and ❑ onsite wetland mitigation areas*. *Please refer to Section C. ❑ For phased projects, provide a master development plan clearing delineating the limits of each phase of construction. d. 0 Paving, Grading, and Drainage Information, which includes, but not necessarily limited to, the following: 0 Existing topography; 0 Boundaries of wetlands and other surface waters and upland buffers(see Section C); 0 Plan view of proposed development; 0 Proposed elevations and/or profiles, including: O roadway, parking, and pavement grades; 0 floor slabs, walkways, and other paved surfaces; 0 earthwork grades for pervious landscaped areas; and O perimeter site grading, tying back into existing grades. Form 62-330.060(1)-Joint Application for Individual and Conceptual Environmental Resource Permit/Authorization to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1),F.A.C.(October 1,2013) Section E,Page 4 of 6 51 Location of all water management areas, including elevations, dimensions, side slopes, and design water depths; 4 Location, size, and invert elevations of existing and proposed stormwater conveyance systems; ❑ Vegetative cover plan for all on-site and off-site earth surfaces disturbed by construction; and D Rights-of-way and easements for the system, including all on-site and off-site areas to be reserved for water management purposes (including access), and rights-of-way and easements for the existing drainage system, if any. e. 0 Stormwater detail information, including but not necessarily limited to, the following: si Cross section of all stormwater management areas, including elevations, dimensions, side slopes, and proposed stabilization measures (with location of the cross section(s) shown on the corresponding plan view); 0 Detail of all proposed control structures, including elevations, dimensions, and skimmer, where applicable; and GI Details of proposed stormwater management systems, such as underdrains, exfiltration trenches, vaults, and other proposed Best Management Practices (BMPs). f. au Location and description of any nearby existing offsite features (such as wetland and other surface waters, stormwater management ponds, and building or other structures) which might be affected by or affect the proposed construction or development. PART 3: CONSTRUCTION SCHEDULE AND TECHNIQUES See Construction Plans Provide a construction schedule, and a description of construction techniques, sequencing and equipment. This information should include, as applicable, the following. a. ❑ Access and staging of equipment; b. si Location and details of the erosion, sediment and turbidity control measures to be implemented during each phase of construction and all permanent control measures to be implemented in post-development conditions. c. ❑ The location of disposal site(s) for any excavated material, including temporary and permanent disposal sites. d. 0 A demolition plan for any existing structures to be removed. e. ❑ Dewatering plan details. If dewatering is required, detail the dewatering proposal including the methods that are proposed to contain the discharge, methods of isolating dewatering areas, and indicate the period dewatering structures will be in place; Note: a Consumptive Use or Water Use permit may be required for dewatering. f. ❑ Methods for transporting equipment and materials to and from the work site. If barges are required for access, provide the low water depths and draft of the fully loaded barge; PART 4: OPERATION AND MAINTENANCE AND LEGAL DOCUMENTATION: a. 0 Describe the overall maintenance and operation schedule for the proposed system. b. El Identify the entity (or entities) that will be responsible for operating and maintaining the system (or parts of the system) to demonstrate that the entity (or entities) meet(s) the requirements of section 12.3 of the Applicant's Handbook, Vol. I. Form 62-330.060(1)-Joint Application for Individual and Conceptual Environmental Resource Permit/Authorization to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1),F.A.C.(October 1,2013) Section E,Page 5 of 6 ❑ If different from the permittee, provide a draft document enumerating the enforceable affirmative obligations on the entity to properly operate and maintain the system for its expected life, and documentation of the entity's financial responsibility for long- term maintenance. ❑ If the proposed operation and maintenance entity is not a property owner's association, provide proof of the existence of an entity, or the future acceptance of the system by an entity which will operate and maintain the system. c. ❑ Provide drafts of all proposed conservation easements, stormwater management system easements, draft property owner's association documents, and plats for the property containing the proposed system. d. 0 Provide legal reservations for access to the treatment system for maintenance and operation by future maintenance entities for subdivided projects. e. 0 Provide indication of how water and wastewater service will be supplied. f. IN Provide a copy of the boundary survey and/or legal description and acreage of the total land area of contiguous property owned/controlled the applicant. PART 5: WATER USE N/A a. ❑ Describe how irrigation will be provided to the project. Will the surface water system be used for water supply, including landscape irrigation, or recreation? b. ❑ If a Consumptive Use or Water Use permit has been issued for the project, state the permit number: c. ❑ If a Consumptive Use or Water Use permit has not been issued for the project, indicate if such a permit will be required.❑yes 0 no❑don't know If yes, please indicate when the application for a permit will be submitted: d. ❑ Indicate how any existing wells located within the project site will be utilized or abandoned. PART 6: SPECIAL BASIN INFORMATION N/A Is your project within a special basin as described in the applicable Applicant's Handbook, Vol. II? yes Eno ❑don't know If yes, please demonstrate that the project will meet the applicable special basin criteria. Form 62-330.060(1)-Joint Application for Individual and Conceptual Environmental Resource Permit/Authorization to Use State-Owned Submerged Lands/Federal Dredge and Fill Permit Incorporated by reference in subsection 62-330.060(1),F.A.C.(October 1,2013) Section E.Page 6 of 6 PUBLIC WORKS PLAN REVIEW COMMENTS �J Ali)/ Date: J J J 1 5 Ini ials: PN ML Project Name/Address : 3 a1 MA ►• ( Application Permit#: J 7 ft.-) 3i3 Check Box Check Application Tracking Comments to Add Box to Comment "Print" IMPS Provide table of impervious surface calculations for entire lot (existing and post construction). ❑ ❑ ESCP Provide erosion and sediment control plans with installation details and maintenance schedule. ID ❑ DPLN Provide drainage plans showing site topography(flow arrows, etc.) ❑ ❑ RMRO All runoff must remain on-site. Cannot raise lot elevation without measures to retain runoff. ❑ ❑ CSMP Provide construction site management plan, including Right-of-Way Permit if using right-of-way for construction parking. ❑ 13 TSUR Provide a pre-construction topographic survey prepared by a Florida Licensed Professional Land Surveyor, showing 1'contours. ❑ ❑ Section 24-66(b)of the Land Development Regulations requires on-site storage for LDCS increased run-off if adding 400 SF or more impervious surface. Provide Delta volume calculations and on-site retention required per Section 24-66(b). (See attached information ❑ ❑ sheet.) PCTS If on-site storage is required, a post construction topographic survey documenting proper construction will be required. ❑ ❑ RWPM A Right-of-Way Permit must be obtained for use ❑ REPM A Revocable Encroachment Permit must be obtained. ❑ PLWP Pool-Wellpoint (if used) must discharge into vegetated area 10' minimum from street or drainage feature (swale, structure or lagoon). ❑ ❑ All concrete driveway aprons must be 5"thick,4000 psi, with fibermesh from edge of DAPR pavement to the property line. Reinforcing rods or mesh are not allowed in the right-of- v' ❑ way. (Commercial driveways-6"thick.) Any utility cuts in the road must be repaired using CO1 Standard Detail Case X and must be URCT overlaid 10 feet in each direction from the center of the cut. Repair must be shown on the ❑ ❑ plans. RWRS Full right-of-way restoration, including sod, is required. ❑ ROFF Roll off container company must be on City approved list and container cannot be placed on City right-of-way. (Approved:Advanced Disposal and Republic Services). ❑ Full erosion control measures must be installed and approved prior to beginning any earth ECIN disturbing activities. Contact Public Works (247-5834) for Erosion and Sediment Control ■ ❑ Inspection prior to start of construction. MEET Recommend Owner/Contractor meet with Public Works Director to discuss proposed construction. Call 247-5834 to make an appointment. ❑ 13 ❑4 �zov� � 5 CoPcl o F ,S-R, in M&D,/,ciaTwc.t 4Pf!/C4 i/04.14 1►Zot/IbL CfiPI-( D1� i DD! R(i6x> '��NL-`L7/G,c.( TC�1�kei% ❑ ,1JU // fig— / 'GC G O/Joc / ///N v/ ( lc d CLARK,GEER,LATHAM ASSOCIATES,INC. Engineers-Ar chitects LL[ T { eF 1172n SEE n n L 3901 Springhill Avenue Mobile,Alabama 36608 www.cglengineers.com DATE 1- I wo.il',\C` (251)344-7073 FAX(251)343-9179 wna„T,o,, lFI�1 1 , 14 I wc � "L U 1- v, n 560\l'Aolc ptiA 141(414iL IV,64t -.. WE ARE SENDING YOU ❑ Attached 0 Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 5 CD , .4 e 5 I, 4l `ni rid u 5 a 4 F S ,.•. _ abk1 L. k if 5 i /V- THESE ARE TRANSMITTED as checked below: yil For Approval ❑ Furnish as submitted ❑ Resubmit copies for review ❑ For your use ❑ Furnish as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 20 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO_ �� � SIGNED: ' A If •ntlo•ur•• are not •• noted. kindly notify v• at onto. z 0 R D -.1 w 0 \ Q § 0 2 l. E -0 d & 0 .. u < = c o 2 ? ± § z ce % $ a CD a.) a a 00J 0 z 0 o < 8 » CO % F- I jg Z 2e \ W 2 \ « 22 ) / E\ E wz X U 2g 5 iw I W w ° a a W § z Z o 2 / 70 0 2 \ ) W \ CI = � Q_ \ \ 5 \ E / } % © E / E2 \ 0 \ e o LT 7 E \ ƒ_ e E = s o / C) & _ —0 / � � � $ ~ D Ca 0 2 $ RO \ S � .i �/ ° % 2 ) a 0 2 0 ± ® \ / 7 { O � \ � \ \ / \ F � e \ < c � � � g 2 = / EE t W U ri oo ® \ 4- 0 (N \ � � �Q3 ± & 3 ± ao = ^ \ 03 to e = 0 \� C . 222 � � ) D -0 7 ° 2 E 0 0 0 ° o J CL "c \ � � o % �2 { 4 0 /\ Z � � 2 � 3 \ 3 .? : z 0 e \ lii » 2 0 a § (X kc. 0 77 / \ .. u « = c 0 c § 2• \ f � co fY % 2 -J w CI) . a 00J 0 z 0 0 « 0 » E _ $ zz \ Z 2I 6 W 2s ®0 E2 , 0 wz E U Z — ) u &cu W § ° 5 re 0 W (N o = z w9 b > � .2 o � f � c \ T13 (0 2 = _ I 0 0 / \ \ k % � n ._ _ — / C3 _ � \ \ / ƒ \ \ \ — E g co 0 \ I - 7 = / % 0 \ / \ / / E0 \\ % a — / e » G \ \ § � . � c0 u, 0 \ O z TD ZI / ms § % / U �_ / s a) c E � � \ / ) \ ) \ f / g ( Q . $ R0 C0 Co / / � \ § o \ ./ To' b i I \ 0 5 / n £ / [ \ a J \ Co' / / 9 » _ / ° ° /\ \t / < f J % co f £ o n / ® § f \ I g \ W U ƒ 0) CO 0 0 C - G � ƒ \ &:/ P « OD _ L'° f ^ \ 0 e y ® C \ 5 7 % _ \ 5 / \ \ o co CU n = .1 / 3 2 t E *2 0 0 4 0 = I ° S w 5 D -0 .c ° 2 0 § 5 0 E \ b \ % ± �./ / c ® \\ a. 7-- \ / � _ % ° ° 0) _ + $ / b ± \ \ ° \ gam _\ Z � � Ty u) \ 3 \\ \ � � \ [ « � \2 � \ f a \ Q O m 2 k = _ .x 2 m = ° ± 4U) ./ o 2 > $ 0 J I— -C .• ci CO E co 0 m u = E E m e a .g c z u) ± c & 0 2 Q £ E Q w rg 0 E to $ CL CO 0) CO ' w m r <— m ,— 5 a O � .g � E § /0_ >- « c 2 CC \ — 2 2 u0 0) \ co / / 0 O « a = o Ste / 6 6 6 6 City of Atlantic each APPLICATION NUMBER Building Department T-:3 Q 71_4, To be assigned by the Building Department.) 800 Seminole Road n�� Atlantic Beach, Florida 322:33-544 I J `, -��Phone(904)247-5826 • Fax(901)247-5$43 0 4 2014 co,�Y City web-site: http://www.coab.us/p I. Date routed: 2 f APPLICATION EVI]E' A.0{0 TRACKING Rif*,hil Property Address: �o�ei / /// 104 • Departure atx review required Yes No ildi . Applicant: J p anninc :Zorn i I ree Administrator Project: /A _ 4110 , / /OP; W./ • •c W.' . ' • L tiliti JO//f1/ Public Safety Review fee $ Dept Signature CONTRACTOR EMAIL Ab ii. m.ESQ T -y,'' Gv e..4s • CONTRACTOR CONTACT APPLICATION STATUS Reviewing Department First Review: DApproved. ZDenied (Circle one.) Comments: cez- BUILDING 56:Ma (6.,y,CA/TS 44 k—if ,4/L PLANNING & ZONING Reviewed by: -W:-.64 Date:/Z // TREE ADMIN. Second Review: Approved as revised. Denied PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review:. DApproved as revised. DDeniecl. Comments: Reviewed by: Date: /BED 092520.14 PUBLIC WORKS PLAN REVIEW COMMENTS Date: /"2 —kJ/ Initials: PN ML Project Name/Address : 23 / �C �"`-' /97j--tro A pplicatior✓Pef mit#: Check Box Check Application Tracking Comments to Add Box to Comment "Print" IMPS Provide table of impervious surface calculations for entire lot (existing and post construction). ❑ ❑ ESCP Provide erosion and sediment control plans with installation details and maintenance schedule. ❑ ❑ DPLN Provide drainage plans showing site topography(flow arrows,etc.) ❑ ❑ RMRO All runoff must remain on-site. Cannot raise lot elevation without measures to retain runoff. ❑ p CSMP Provide construction site management plan, including Right-of-Way Permit if using right-of-way for construction parking. ❑ ❑ TSUR Provide a pre-construction topographic survey prepared by a Florida Licensed Professional Land Surveyor, showing 1' contours. ❑ ❑ Section 24-66(b) of the Land Development Regulations requires on-site storage for LDCS increased run-off if adding 400 SF or more impervious surface. Provide Delta volume calculations and on-site retention required per Section 24-66(b). (See attached information ❑ ❑ sheet.) PCTS If on-site storage is required, a post construction topographic survey documenting proper construction will be required. ❑ ❑ RWPM A Right-of-Way Permit must be obtained for use ❑ ❑ REPM A Revocable Encroachment Permit must be obtained. ❑ ❑ PLWP Pool—Wellpoint (if used) must discharge into vegetated area 10' minimum from street or drainage feature (swale, structure or lagoon). ❑ ❑ All concrete driveway aprons must be 5" thick, 4000 psi, with fibermesh from edge of DAPR pavement to the property line. Reinforcing rods or mesh are not allowed in the right-of- ❑ ❑ way. (Commercial driveways—6" thick.) Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be URCT overlaid 10 feet in each direction from the center of the cut. Repair must be shown on the ❑ ❑ plans. RWRS Full right-of-way restoration, including sod, is required. ❑ ❑ ROFF Roll off container company must be on City approved list and container cannot be placed on City right-of-way. (Approved: Advanced Disposal and Republic Services). ❑ ❑ Full erosion control measures must be installed and approved prior to beginning any earth ECIN disturbing activities. Contact Public Works (247-5834) for Erosion and Sediment Control ❑ ❑ Inspection prior to start of construction. MEET Recommend Owner/Contractor meet with Public Works Director to discuss proposed construction. Call 247-5834 to make an appointment. El ❑ ❑ ❑ ❑ ❑ Showman, Lisa From: Layton, Douglas Sent: Thursday, December 11, 2014 10:32 AM To: Carper, Rick; Simmons, Ricky L; Showman, Lisa Subject: FW: 2321 Mayport Rd Dollar Tree FYI From: Graham, Shirley Sent:Thursday, December 11, 2014 10:26 AM To: Arlington, Daniel; Hubsch, Jeremy; Reeves, Derek; Layton, Douglas; Walker, Jennifer; Jones, Mike; Escanio, Rey Cc: maldred(acglengineers.com Subject: 2321 Mayport Rd Dollar Tree To All: Please send all review comments to maldred @cglengineers.com. Thanks Shirley Graham City of Atlantic Beach Building Permits Technician Atlantic Beach, Fl 32233 904 247 5800 sgraham@coab.us 1 Showman, Lisa From: Simmons, Ricky L Sent: Friday, December 12, 2014 7:40 AM To: Showman, Lisa Subject: FW: Dollar Tree - 2321 Mayport Road - PW Review Comments Attachments: CityReviewcomments_DollarTree 12-11-14.docx Rick Simmons Deputy Public Works Director City of Atlantic Beach 1200 Sandpiper Ln. Atlantic Beach, Fl. 32233 Ofc. 904.247.5834 Cell 904.545.2759 rsimmons@coab.us From: Carper, Rick Sent: Thursday, December 11, 2014 1:21 PM To: maldred@cglengineers.com Cc: Simmons, Ricky L Subject: Dollar Tree - 2321 Mayport Road - PW Review Comments Mark, I got your voicemail this morning and will call shortly, but wanted to send the attached for review before calling. Rick Ricky L. Carper, P.E. Deputy Public Works Director City of Atlantic Beach 1200 Sandpiper Lane Atlantic Beach, FL 32233 rcarper a(�coab.us PH: (904)247-5834 Fax: (904)247-5843 • G--) 0O -0 > p 0$ $g / \ -n g \ $ 2)$ —I cr / - a � D �a q Ct '• 1:1 ƒ � q O _ » A § e 2 \ u ® 2 / m 7 s' m D \ n O 2 2 2 ) U co 2 2 2 rr = -I I- \ § mc82 \ 3 ® § O D / \ ?CL / C C / / 0m ƒ = x eoa & n 5 - - 0. C — m -0 \ 9e 7 \ $ \ 2 ■ 2 / aG — \* -« m -u..-<` r Ca \ / � \ / � co \ � � � — = O — L_ ® " _ > CD � C � P \ 23 0 / o \ a ƒ 33 3 -' D0 � . X ƒ \ 0 2 \ / \ \ \ I « Cl) B / ~ O & f § 0 0 / cr / 3 -I / O k / = * / ® ± a mm & -' E @ m / e D f % \ \ ƒ -C3 73 / = j m / a - E \ j \ Z 0 0 ® X m < Q � m M 0K o z 0 O 0 g II K0 g › m Z ¥ -1 -I Cn 2 « w > n 2 0 z O ƒ Ev . £ I- CD o m ® $ 2 Z 2 w -4 § � . n = a > § 2 0 \ •• - z $ / \ \ m C a 0 z City of Atlantic Beach APPLICATION NUMBER lb Building Department T T (To be assign by the Building Department.) 800 Seminole Road ! '_ A.�/ ��i� / �/Y �� ' �� l'' Atlantic Beach,Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-pLCS 0 3 2015 . E-mail: building-dept @coab.us Date routed: Z 1 5. City web-site. httpl/www coab.us __ t APPLICATION REVIEW AND TRACKING FORM Property Address: �� /I� Q er IC d II.:.,.:s: t review re•uired Yes No Applicant: �� 4 Planning&Zonin• _-IIIIII Project: 17)o 1)4 r++ �• 4�ub • •Works ubli Works == Public Safety = Viiô /1 S .- - _ ■�IIIII Review fee $ Dept Signature Review or Receipt ' Other Agency Review or Permit Required of Permit Verified B Date 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: ❑Approved. ,Denied. ____ i (Circle one.) Comments: 2RF ir/ 0` S r �y-3 v.�•�.ie�s F_ BUILDING /-,oE,�T /.LL PLANNING&ZONING Reviewed by: 4,14-2,_______ Date: Z/�'/,, TREE ADMIN. -- -- Second Review: ['Approved as revised. Denied. PUBI IC WORKS Comments:'---?PUBLIC UTILITIES (ve f PAF,,/d u S OPYlk" 6-../.>s PUBLIC SAFETY Reviewed by: _ Date: ZI/SJ FIRE SERVICES Third Review: Roved as revised ['Denied. Comments: c>u63 Reviewed by: 4 c Date: 3 / Revised 07/27/10 City of Atlantic Beach JAN 0 8 APPLICATION NUMBER ,• ` Building Department 2015 (To be assign-. by the Building Department) 800 Seminole Road '? 1.\; Atlantic Beach, Florida 3223 Id - ..4.' " Phone(904) 247-5826 • Fax(904)247-5845 . E-mail: building-dept @coab.us �, /i is L'_ Date routed: City web-site http://www coab.us J/ (� �- APPLI ATION REVIEW AND TRACKING FORM Property Address:,_ / i ' //1 , O j & Department review required Yes No Buil.•.. Applicant:. tanning&Zoni Tree Alministrator Project: JJJ4- tic Wor c Public Utilities Public Safety ire Services Review fee $ Dept Signature Review or Receipt Other Agency Review or Permit Required of Permit Verified By Date 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: I APPLICATION STATUS - ._ Reviewing Department First Review: UApproved Denied. (Circle one.) Comments: BUILDING f CEE f� 0L`'Cb PLANNING&ZONING Reviewed by Date: //9 A J TREE ADMIN. Second Review: pproved as revised. ( 'Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by:�� (- C" (' Date: -3 /9 S FIRE SERVICES Third Review: :_enied ❑Approved as revised. �'_ Comments: Reviewed by: Date: Revised 07/27/10 Clark, Geer, Latham & Associates, Inc. Engineer•Architect 3901 Spring Hill Avenue West•Mobile,Alabama 36608•251/344-7073•FAX 251/343-9179 j. Quality and performance specifications of all yard and interior fire protection components. Interior piping will be black carbon steel per NFPA 13, Schedule 10 for distribution as noted on FP-1.1. Exterior piping will be C900 PVC as indicate on drawing C-9.0. All components shall conform to NFPA 13 and local requirements as noted on drawing FP-1.1, notes 3, 6, & 7. 3. Contractor submittals which deviate from the above minimum design parameters shall be considered material deviations and require supplemental engineering approval and documentation. Acknowledged 4. In the event the Engineer of Record provides more information and direction than is established above, he or she shall be held responsible for the technical accuracy of the work in accordance with applicable codes, standards, and sound engineering principles. Acknowledged Please feel free to call if you have any questions regarding these responses. Thank you, r Mark M. Aldred, AIA 3