850 SEMINOLE RD - COMCAST RIGHT OF WAY siAlP,. .... City of Atlantic Beach APPLICATION NUMBER
6:51 :04111!n Building Department � i c, (To be assigned by the Building Depart nt.)
J- , :. . 800 Seminole Road P,� _ / /,>• Atlantic Beach, Florida 32233-5445 ; 8 L .' w • a
�� Phone(904)247-5826 • Fax(904)247-5845-P
)'U-,it jr V E-mail: building-dept@coab.us 4 zO/S / Date routed: t Afff
City web-site: http://www.coab.us • : ,```` /
APPLICATION REVIEW AND ACKING FORM
Property Addres : & 4Z & tu- I WO It --r Department review required Yes No
_
Applicant: OA 0 Building��l Planning &Zoning _
Tree Administrator
Project: U/ TV ublic W
r- tilitier�
Public Safety
Fire 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: [ pproved. ❑Denied.
(Circle one.) Comments: yj �� efi✓f
�(�l 17��21%l%�liA ���K�tl
BUILDING
PLANNING &ZONING Reviewed by:// } CL.. i —J Date: g78// s.----s.----TREE ADMIN. V
Second Review: 4 ( pt ved as revised. ❑denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES '�- /'Pr` /lab -•
PUBLIC SAFETY Reviewed by.AI. -! Date:
FIRE SERVICES Third Review: ['Approved as revised/ rlDenied. i/
Comments:
Reviewed by: Date:
Revised 07/27/10
1.J.v..p.,z� City of Atlantic Beach t�, APPLICATION NUMBER
Js r Building Department * - (To be assigned by the Building Depart nt.)
r ' 800 Seminole Road SF �� b -,41() -- e
:: Atlantic Beach, Florida 32233-544 -hop I��JJJ
w_ Phone(904)247-5826 • Fax(904)t?47--5845 411 I
'��;���• E-mail: building-dept @coab.us / Date routed: i iff
City web-site: http://www.coab.us ��
APPLICATION REVIEW AND TRACKING FORM
Property Addres & 4D S AA- 1 r ed De art
ment review required Yes No
_
Applicant: can, C 8�l Building
Planning &Zoning
Tree Administrator
Project: 0ArV (�blic Wo
Public Safety
Fire Services
Review fee $ ,/ Dept Signature w .__
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:
APPLIC TION STATUS
Reviewing Department First Review: Approved. ['Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING 1"----
Reviewed by: V... — Date: 01/(S——
TREE ADMIN. Second Review: ['Approved as revised. ❑Denied.
�' �� !l1/ORKS Comments:
- ,_4711;i1Tsjg.S.---
PUBLI SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
141*",.;,, CITY OF ATLANTIC BEACH
'J 800 SEMINOLE ROAD
rJ ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
"'.2-f)11191>
RIGHT OF WAY PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROW-2108
Job Type: RIGHT-OF-WAY PERMIT
Description: CATV FOR COMCAST
Estimated Value:
Issue Date: 9/10/2015
Expiration Date: 3/8/2016
PROPERTY ADDRESS:
Address: 850 SEMINOLE RD
RE Number: 170389-0000
PROPERTY OWNER:
Name: CITY OF ATLANTIC BEACH
Address: 800 SEMINOLE RD
PERMIT INFORMATION: UTILITY DEPT.: PUBLIC WORKS:
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.
Full erosion control measures must be installed and approved prior to beginning any earth
disturbing activities. Contact Public Works (247-5834) for Erosion and Sediment Control
Inspection prior to start of construction.
All silt must remain on-site during construction.
Full right-of-way restoration, including sod, is required.
Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be
overlaid 10 feet in each direction from the center of the cut. Repair must be shown on the
plans.
FEES:
PERMIT IS APPROVED ONIX IN ACCORDANCE WITH ALL CIIN OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
Sj1
800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
��'��Fil�r
Total Payments: $0.00
PI:K'IIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
IS I ILDING CODES.
, 9r_it,„
���, P-�y� CITY OF ATLANTIC BEACH
;, CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
® li. 404 800 Seminole Road 904-247-5800
Atlantic Beach,Florida 32233-5445 Fax 904-247-5845
Date 9/01/15 Permit#
Job Address 850 Seminole Rd
Permitee: COMCAST Telephone#904-626-2092
Permittee Address:5934 Richard St,Jacksonville, FL 32216
Requesting Permission to Construct:525' Underground CATV facilities at850 Seminole Rd Node BE0441Project 800 Seminole
Location: (Reference to Cross-Street) Plaza St near Seminole Rd
1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial
and underground and the accurate locations are shown on the sketches.
A Letter of Notification was mailed to the following Utilities/Municipalities:
Jacksonville Electric Authority Yes(X No ( ) Date: 4/111/15
Bell South Telephone Company Yes(X No ( ) Date: 9/01/15
Tecol Gas Yes( No ( ) Date: 9/01/15
Com cast Yes( No ( ) Date:
2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation, alteration
or relocation of all,or any portion of said street or easement as determined by the Director of Public Works,any or all
of said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately
removed from said street or easement or reset or relocated hereon as required by the Director of Public Works, and
at the expense of the Permittee unless reimbursement is authorized.
3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be
performed under the supervision of Tim Solomon(Contractor's Project Superintendent)
located at 5934 Richard St,Jax, FL 32216 Telephone#:904-626-2092 _
4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee.
5. All city property shall be restored to its original condition as far as practical,in keeping with city specifications and the
manner satisfactory to the city.
6. A sketch of plans covering details of this installation, as well as, a copy of a recent survey shall be made a part of
this permit. Calculations showing any increase in impervious area on owner's lot or in the city Right of Way are to be
included with this application.
7. This permittee shall commence actual construction in good faith with 30 days. If the beginning date is
more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public
Works to make sure no changes have occurred in the area that would affect the permitted construction.
8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's
right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all times,
assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and all
loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of
the aforesaid rights and privileges.
9. The Director of Public Works shall be notified twenty-four(24)hours prior to starting work and again immediately
upon completion.
OWNER RZ --
Signed: ' -'- Date: q . I . I `J
Before me this 1 day of in the County of Duval,
State Of Florida,has personally appeared 1( 1 P _29 _
Notary Public at Large,State of Florida,County of Duval.
My commission expires: _
Personally Known: \/' or
Produced Identification:
( ""'••. OLIVIA BERRIOS
4 ;�°��Pi�. �:- Notary Public-State of Florida
' • • My Comm.Expires Dec 10,2017
--,±,,,-...--09.4),$ Commission # FF 46800
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1•, CITY OF ATLANTIC BEACH
„:, + �' CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
■:, n
800 Seminole Road 904-247-5800
i� �, `` Fax 904-247-5845
�'' Atlantic Beach,Florida 32233-5445
fl'l_
Date 9/01/15 Permit#
Job Address 850 Seminole Rd
Permitee: COMCAST Telephone#904-626-2092
Permittee Address:5934 Richard St,Jacksonville, FL 32216
Requesting Permission to Construct:525' Underground CATV facilities at850 Seminole Rd Node BE0441Project 800 Seminole
Location: (Reference to Cross-Street) Plaza St near Seminole Rd
1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities,both aerial
and underground and the accurate locations are shown on the sketches.
A Letter of Notification was mailed to the following Utilities/Municipalities:
Jacksonville Electric Authority Yes(X No ( ) Date: Q/f11/15
Bell South Telephone Company Yes(X No ( ) Date: 9/01/15
Tecol Gas Yes( No ( ) Date: 9/01/15
Corn cast Yes( No ( ) Date:
2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation, alteration
or relocation of all,or any portion of said street or easement as determined by the Director of Public Works,any or all
of said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately
removed from said street or easement or reset or relocated hereon as required by the Director of Public Works, and
at the expense of the Permittee unless reimbursement is authorized.
3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be
performed under the supervision of Tim Solomon(Contractor's Project Superintendent)
located at 5934 Richard St,Jax, FL 32216 Telephone#:904-626-2092 _
4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee.
5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications and the
manner satisfactory to the city.
1 6. A sketch of plans covering details of this installation, as well as, a copy of a recent survey shall be made a part of
this permit. Calculations showing any increase in impervious area on owner's lot or in the city Right of Way are to be
included with this application.
7. This permittee shall commence actual construction in good faith with 30 days. If the beginning date is
more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public
Works to make sure no changes have occurred in the area that would affect the permitted construction.
8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's
right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all times,
assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and all
loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of
the aforesaid rights and privileges.
9. The Director of Public Works shall be notified twenty-four(24) hours prior to starting work and again immediately
upon completion.
OWNER .A--- `�-'"j
Signed: Date: 9" l4_
Before me this I day of –.,–.. in the County of Duval,
State Of Florida,has personally appeared Ai i C 1 e -1 � _
Notary Public at Large,State of Florida,County of Duval.
My commission expires: –
Personally Known: ‘.,./ Am. _AN, or
Produced Identification: ♦ — - AIM-
OLIVIA BERRIOS
;•r° .1-`�'; Notary Public -State of Florida
* • ; •:My Comm Expires Dec 10,2017
=. �rr-.,.'o; Commission # FF 46800
Bonded Through National Awl
•
September 1, 2015
City of Atlantic Beach
800 Seminole Rd
Atlantic Beach, FL 32233
To Whom It May Concern:
I am writing to inform you that Comcast Communications is proposing to install 525'
underground CATV as shown on the attached plans. Please review the attached drawings
and information to provide an approved permit.
If any additional information is needed, please advise. I may be contacted as shown
below.
Thank you.
Billie Lentes
Authorized Agent of Comcast Cable
Lentes Design, Inc.
Special Projects Manager
4550 Palmetto Cove Ln
Jacksonville FL 32258
(904)-730-0068-W/F
(904)-651-7642-C
lentesdesign @comcast.net