552 PELICAN KEY - RIGHT OF WAY (2) JS,
CITY OF ATLANTIC BEACH
r A S 800 SEMINOLE ROAD
j .-• - ,__ ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RIGHT OF WAY PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION
Job ID: 15-ROW-1456
Job Type: RIGHT-OF-WAY PERMIT
Description: REPLACE EXISTING DWAY AND SIDEWALK WITH PAVERS,
Estimated Value:
Issue Date: 6/29/2015
Expiration Date: 12/26/2015
PROPERTY ADDRESS:
Address: 552 PELICAN KEY
RE Number: 172027-5576
PROPERTY OWNER:
Name: FARRA, GABRIEL &ANN D, *
Address: 552 PELICAN KEY
PERMIT INFORMATION: PUBLIC WORKS: UTILITY DEPT.:
This permit allows replacement of existing concrete drive, sidewalk and porch with pavers. No
additional areas, causing an increase in impervious surface, are requested or permitted.
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. Surround work area with silt fence.
All silt must remain on-site during construction.
Any sidewalk must continue as concrete through pavers.
Roll off Container Company must be on City approved list and container cannot be placed on
City Right-of-Way. (Approved: Advanced Disposal, Realco, Republic Services, Shappel's and
Waste Pro). Dumpsters, portable toilets and parking are not allowed on right-of-way.
Full right-of-way restoration, including sod, is required.
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLAN'T'IC BEACH ORDINANCES AND 7• 1E FLORIDA
BtfiH;BlN6-CODES. ---- ...-------------
e 4,:IV CITY OF ATLANTIC BEACH
A \S) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible.
A sewer cleanout must be installed at the property line. Cleanout must be covered with an
RT1 concrete box with metal lid. Cleanout to be set to grade and visible.
FEES:
Fence/ROW $35.00
Total Payments: $35.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND 771E FLORIDA
BUILDING CODES.
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CITY OF ATLANTIC BEACH
® 1 ` 1`` CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EA
800 Seminole Road �ur"1�►.r
��;a�DP Atlantic Beach,Florida 32233-5445 _?•• �' l:,� i v `
PLEASE SUBMIy (COMPLETE SETS OF PLANS WITH APPL C ' !p F. 904-247-5845 .... ,
..... j �ry�oN ��4�Q JUN 1 '
Date 1�
Job Address
I PERMIT# By ,a ,
ISSUED BY THE CITY
Permitee: - lot ' et... 0
Telephone* O — 2- /— J
Permittee Address: '
er.--I1
Requesting Permission to Construct:
Location: (Reference to Cross-Street) *hi �- �, =- - • �`� •
1. Applicant declares that prior to filing this application he has ascertained the location of all exi '
both aerial and underground and the accurate locations are shown on the sketches. strng utilities,
A Letter of Notification was mailed to the following Utilities/Municipalities:
Jacksonville Electric Authority
Bell South Telephone Company Yes ( ) No ( ) Date:
Ferrell Gas Yes( ) No ( ) Date:
Comcast Yes ( ) No ( ) Date:
Yes( ) No ( ) Date:
2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient
alteration or relocation of all, or any portion of said street or easement as determined by the Director of
Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenance operation,
hereunder, shall be immediately removed from said street or easement or reset or relocated he Public
s authorized
required by the Director of Public Works,.and at the expense of the Permittee unless reimbursement is
authorized. hereon as
3. All work shall meet City of Atlantic Bea h or Florida Department of Transportation Standards e
performed under the supervision of ,r arils and be
Superintendent) located at (Contractor's Project
4. All materials and equipment shall be s jec to inspection by the Director of P blic Work o:
5. All ci �e�_?',��,7 1
city property shall be restored to its original condition as far as practical, in keeping kwithrcity speciifications
and the manner satisfactory to the city.
6. A sketch of plans covering details of this installation, as well as, a co
part of this permit. Calculations showin• an increase in imservious area on owner's lot or in the cit
Riht of il'i/ay are to be included with this application
copy of a recent survey shall be made a
7. This permittee shall commence actual construction in good faith with
more than 60 days from date of permit approval, then permittee must review the permit with the Director of
Public Works to make sure no changes have occurred in the area that would affect the permitted construction.
days. If the beginning date is
8. It is understood and agreed that the rights and privileges herein set out are granted only to the exten t of the
City's right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all
times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and
against any and all loss, damage, and cost of expenses arising in any manner of the exercise or attempted
exercises by the holder of the aforesaid rights and privileges.
9. The Director of Public Works shal se notified twenty-four (24) hours prior to starting work and • •
immediately u.on co ple io,
/ again
OWNER 4- �.j
Signed: ���, /� _/ �) f
Befor me Phis D't day or [ AC in the Ct of Duv �•.. •a EY,PIRES:April 24,2017
State Of Florida,ha p•rsonally appeared (�
•
Notary Public at tar e,Sfafe• {/�' rr
''74:;:v:as BondedThruNotary PublicUndenwrrters
•
9 �f lori a, count ofDuva o I
��.'/I s ! e?sires:
Produced Identification Personally y Knotvn:
If 1 wr ' wily Ali DU, •
Permit Attachment of for
Permit# issued ,20_Atlantic Beach,FL 32233
Owner's Name: Property Address:
R.E.#:
•
Subdivision: Lot#/Block#:
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this /7 day of ,20 ,'
by Atlantic Beach, Florida, a municipal corporation organized and existing under lEe laws of the State of
Florida, hereinafter referred to as "CITY" and
hereinafter referred to as"USER". of Atlantic Beach; Florida,
WITNESSETH:
That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to
enter upon the property of the City of Atlantic Beach for the purpose as described in the City of Atlantic
Beach Right-of-Way/Easement permit numbers noted above(copies attached).
This work is generally described as: /04 Ve,e67, Ulf/ye
pi)
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains
subject to relocation or removal on thirty(30)days notice by CITY to the USER, said notice to USER shall be
given by certified mail, return receipt requested, to the following address:
The depositing of said notice of cancellation in the United States mail shall constitute the notice of
cancellation and the burden is upon USER to keep the CITY informed of USER's proper address.
The USER shall promptly make any and all necessary repairs to any facility erected or maintained in the
exercise of the privilege herein granted and shall at all times maintain said facility in good and safe condition.
In the event it is necessary for the CITY or the City's approved representative or other franchised utility to
enter upon the above-described property of the CITY, the USER shall replace at the USER's sole expense,
any and all material necessarily displaced during the action of maintaining,repairing, operating,replacing,or
adding to of the utilities and facilities of the CITY or franchise utility provider.
The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes,
Land Development Code,and all other land use and code requirements of the CITY, including
City Code Section 19-7(h)which states"Driveways that cross sidewalks: City sidewalks may not be replaced
with other materials, but must be replaced with smooth concrete left natural in color so that it matches the •
existing and adjoining sidewalks."
Page 1 of 2
The USER, prior to making any changes from the approved plans and/or method, must obtain written
approval from the City of Atlantic Beach,Public Works Department,for said change. The USER shall,at the •
discretion of the CITY, be requested to submit as-built drawings showing the change within thirty(30) a
after the day of completion. ) dy s
This permit shall insure to the benefit of, and be binding upon; the USER and their respective successors and
assigns.
USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws
and/or specifications, to include utilities locate requirements and use limitations/requirements of public
rights-of--way and other public land. USER further agrees that the CITY and its officers and employees shall
be saved harmless by the USER from any of the work herein under the terms of this permit and that all of said
liabilities are hereby assumed by the USER.
DATED and SIGNED this I I t4
day of C vCA,A. ,20/5
By. Flu (.1:4 00-- Z$Q-_Sta- 21 1 _ 0
Property Owner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY QF DUVAL
On this (�,� ay of_�'�/i�C.
and for aid County 2ersonally appeared before me, a Notary Public in
1 (� . 1 d State, �� L
Atlantic Beach,Florida,known to me t be the person(s)described in
and who executed the foregoing •I , le ent; who acknowledged to me that he or she executed the same freel
and voluntarily and for the uses and purposes therein mentioned. y
wr, °• JENNIFER WALKER
Notary Public in for said County and State . '
,. • :+- MY COMMISSION b Fi 011460
,:y € EXPIRES:April 24 2017
CITY OF ATLANTIC BEACH, FLORIDA, a ���Thn,NOM Pub!
c IJndenvr lers
municipal corporation:
Approved:
Doug Layton,public Works Director
For Permits where city sidewalk is impacted,
City Manager approval required:
,
•
Nelson Van Liere,City Manager
I
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Page 2 of 2
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MAP SHOWING SURVEY OF
LOT 90, SELVA LAKES UNIT TWO, AS
CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.LT BOOK 43, PAGES 11, 1JA AND 118, OF THE•
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City of Atlantic Beach JUN
%;` Building Department 2 2 2015 APPLICATION NUMBER
– - - .:,`` , 800 Seminole Road E (To be ssi n
' q b the Building
Atlantic Beach, Florida 32233-5445 �
Phone(904)247-5826 • Fax(904)247-584 `
?,�; �r E-mail: building-dept @coab.us
City web site: http://www.coab.us Date routed:
APPLICATION REVIEW AND TRACKING FORM
Property Address: 5520 PELT(AN I Department review required Yes No
mI Building
Applicant: Planning&Zoning
Rt `L ��' a• inistrator
Project: n 411. A
etWQ y p=it Sri' Public Utilities W/ �v •
�rI1 Fire Services
Review fee $ _ Dept Signature
Other Agency Review or Permit Required Review or Receipt
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:
APPLICATION STATUS _
Reviewing Department First Review: PrApproved.
['Denied.
(Circle one.) Comments:
BUILDING „_,----J.7 C ,--. --s t
PLANNING&ZONING
Reviewed by: �-fe. �-- Date: G/.2f4".--
TREE ADMIN.
Second Review: DApproved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY — Reviewed by:
—_ Date:
FIRE SERVICES Third Review: ❑Approved as revised.
['Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
•rS1.A7,; City of Atlantic Beach ,
`' '�, \
t`' .`,� Building Department -r�T APPLICATION NUMBER
�' 800 Seminole Road JUN 2 2 L (To be ssign b the Bu'Iding ep rtr e t.)
,�v /// Atlantic Beach, Florida 32233-5445 X015
I all�.r ��
• Phone(904)247-5826 • Fax(904)247-5845
-'" ,,i; Tyr E-mail: building-dept @coab.us •City web-site: http://www.coab.us ~ Date routed:
� iI
—
~
APPLICATION REVIEW AND TRACKING FORM
Property Address: 552 PE.LICAIV K -- q
1 Department review re uire
--- q d r�-, No
Applicant: GAf3RA � Building
Planning
&Zoning
_-
T -- -:ministrator _-
Project: Rlc p L -eL
tW Q � CWA (K--wr rri' 11 Public Utilities
EN
—'u. c a e y CAD Fire Services 11111
lied/ s P� Iry b1
Review -
-
-
fee $____ � Dept Signature_1`
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St. Johns River Water Management District IIIIIIIIIIIII
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved.
(Circle one. ['Denied.
Comments:
BUILDING
PLANNING&ZONING Reviewed b
TREE ADMIN.
by: Date: G Z ��
Second Review: ❑Approved as revised. ['Denied.
LIC WOR S C.mments:
PUBLIC UTILITIES
P BLIC SAFE /y Reviewed by:
Date:
FIRE SERVICES Third Review: L]Approved as revised.
['Denied.
Comments:
Reviewed by:
Date:
revised 07/27/10
PUBLIC UTILITIES PLAN REVIEW COMMENTS
Date:
69(,)-4,1 Initials:
Project Name/Address: SSA- ICI \bow k€-
1 Application Permit#: 13 -1Q(..) V' - I 'S 7
Check Box Check
Application Tracking Comments to Add Box to
Comment "Print"
UWSU Avoid damage to underground water/sewer utilities. Verify vertical and horizontal ❑ ❑
location of utilities. Hand dig if necessary. If field coordination is needed, call 247-5834.
MBSC
Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. g
RT1C A sewer cleanout must be installed at the property line. Cleanout must be covered with
an RT1 concrete box with metal lid. Cleanout to be set to grade and visible.
RPZB A reduced pressure zone backflow preventer must be installed if irrigation will be
provided or if there is a private well on the property. Backflow preventer must be tested ❑ ❑
by a certified tester and a copy of the results sent to Public Utilities.
STRM Plans note the building will be unsprinkled. If plans change, any fire line installed must be
metered with a Sensus touch-read meter in a properly sized vault and an appropriate ❑ ❑
backflow preventer installed. Backflow preventer must be tested by a certified tester and
a copy of the results sent to Public Utilities.
FSBR If fire sprinkler system is provided, contact Malcolm Clemons at 247-5839 for backflow
❑ ❑
requirements. At a minimum, will require a double check backflow preventer.
FLM Fire lines must be metered with a Sensus touch-read meter. Meters larger than 2" must
❑ ❑
be installed in a vault as noted in JEA specifications.
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