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712 SELVA LAKES CIR - DRIVEWAY - r,J,l�_, ie < Jai . �' ; ��5, CITY OF ATLANTIC BEACH l 800 SEMINOLE ROAD . °�'�� ATLANTIC BEACH, FL 32233 \ INSPECTION PHONE LINE 247-5814 z...r:t J,31>'r DRIVEWAY PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-DWAY-312 Job Type: DRIVEWAY Description: PAVER DRIVE WAY Estimated Value: Issue Date: 3/3/2016 Expiration Date: 8/30/2016 PROPERTY ADDRESS: Address: 712 SELVA LAKES CIR RE Number: 172027-5838 PROPERTY OWNER: Name: MCCAULEY, BEVERLY JANINE Address: 712 SELVA LAKES CIR 4 PERMIT INFORMATION: PUBLIC WORKS: UTILITY DEPT.: Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of construction. All silt must remain on-site during construction. Roll off container company must be on City approved list and container cannot be placed on City Right- of-Way. (Approved: Advanced Disposal, Realco, Republic Services, Shappel's and Waste Pro.) Full right-of-way restoration, including sod, is required. 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 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Total Payments: $35.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Js;;sr=‘,,i;„,� 'City of Atlantic Beach APPLICATION NUMBER Building Department I (To be assigned b .=-. - -f.,, 800 Seminole Road C`L:I 9 by the Building Department.) w ' y: ., Atlantic Beach, Florida 32233-5445 v ��r 6 .- g — 3/Z- - Phone(904)247-5826 • Fax(904)247 5845 FEB 0 9 2016 \.or31c E-mail: building-dept @coab.us City web-site: http://ww.coab.us BY: Date routed: f� ,r w APPLICATION REVIEW AND TRACKING FORM Property Address: -7/a —C ✓a 6/...65. OG De artment p review required Yes No , 1 Building Jt) Applicant: D [mo E. e_ Planning &Zoning /�,, �� Tree Administrator Project: ' � Ni/' �.(�/� ._ /"A L��eJ - . . A • . ublic Utilities Public Safety Fire Services Review fee $ Zf Dept Signature ' ci.) 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 Qistrict Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLIC ATION STATUS Reviewing Department First Review: Approved. ['Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: i rGw Date: 2/6 l?G TREE ADMIN. Second Review: []Approved as revised. ❑Denied. � BLIP R� Comments: - PUBLIC UTILITIES PUBLIC SA ETY Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. ❑Denied. Comments: Reviewed by: Date: tevised 07/27/10 1 01-evir,�, City of Atlantic Beach APPLICATION NUMBER J Building Department IRE CEIVED (To be assigned by the Building Department.) r 4 800 Seminole Road FEB 0 r� Atlantic Beach, Florida 32233 5445 9 2��6 /6 - ���, Phone(904)247 5826 Fax( 4� 47-5845 �J;ti)r E-mail: building-dept @coab.0 r_ Date routed: l City web-site: http://www.coab.us —` __ _ APPLICATION REVIEW AND TRACKING FORM l Property Address: 7/a --CI ./✓c_ (a 6 S /G: Department review required Yes No • Building Applicant: Q a c e_ Planning &Zoning �� W y._ .-PpVi T re Ad for Project: u1i _ ' ublic Utilities 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: 1pproved. ❑Denied. (Circle one.) Comments: ie e ithlapd 4fitift44 BUILDING PLANNING &ZONING I � Reviewed by: 1�� % i 511,rr'Date: Z/1(/1.6 TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑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 ti 0- 6 ?6 An° ''. ./y '../ `‘ CITY CF ATLANTIC BEACH is I'mu Or‘1 CONSTRUCTION PERMIT WITHIN CITY RIGHTS OFD .AND EASEMENTS . ck s. BOO Seminole Road ' 1__ '' ' ' k Atlantic Beach,Florida 32233-5445 ` ~Vi ��;:sv PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION. r. Date 01.S ao l �,� F - • 2016 4 V \ /� IL UED= - Job Address I a S.e..1 Jc., ,.. .,, Ly-d....., Permitee: R qa.e.Nr 5 o r■ fiao•er, 'ZnC Telephone# 9 04-as- - - 3 Permittee Address: )aLi ki ►`t^ry-ac.J■ecS Te,srrae_p�, CS A-C.Ak. 0tti si , 11�, �� 3 �-a- --s Requesti Permission to Construct: to T,P,a.e.�r*t.e r ck xi Et► Ite:u-cc.)Q1 4- Pra.-�(o ri II Location: (Reference to Cross-Street) 1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and undergrou d and the accurate locgons are shown on the sketches. U.):; l 1 milk l I r \ o c. - C�a c.7 J u. fa-�-�,,-- A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority Yes ( ) No ( ) Date: Bell South Telephone Company Yes( ) No ( ) Date: Ferrell Gas Yes ( ) No ( ) Date: Comcast 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 Be ch or Florida alrtment of Transportation Standards and be performed under the supervision ofry n (Contractor's Project Superintendent) located at 7 I -S e.l J cx. 1,,,K.0 e.,1 rci c Telephone* gal. a s I s S93 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 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 y"..- Signed: / / / / C��� /yy�' �_ g /& MIRIAM GRIFFIN Before me this ,/ day of Jaw/ in the 9u ty/Af Duv}I, �.� _A% Notary Public,State of Florida State Of Florida,has personally appeared -:): P r ._/ "(L.( ra ti (`C. , 2 �' Commission#FF 163906 Notary Public at Large,State of Florida,County of Dtw l tt ;iii; My comm.expires Oct.14,2018 My commission-expires: /f1--/y— r2 e%/ Personally trio■ : !/ Produced Identification: ..it ___'_____ . -_-_--- ____'_'--_-_ __ i - -.�+ - - --_ ` � _ ii. - -__ _ I ---- 1111: -_ - --'__� iixilili:::-~---------------- -----'----------------'---~---'------------- - _ _ ___-_-__-'-_--'----------------`------------'-----'-------�---`---~~~-~------' ._---_-___. | / . R.O.W. Permit Attachment of for R.O.W.Permit# issued ,200_ Atlantic Beach,FL 32233 Owner's Name: Property Address: Subdivision: Lot#/Block#: R.E.#: REVOCABLE ENCROACHMENT PERMIT THIS REVOCAB1. . ENCROACHMENT PERMIT, issued on this ' 5... day of iir,44,44 , 209% by Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of the State of Florida, hereinafter referred to as"CITY" and 14,, e 1,¢41 of Atlantic Beach,Florida,hereinafter referred to as"USER". WITNESSETH: That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of Atlantic Beach Right-of-Way/Easement permit numbers noted above (copies attached). This work is generally described as: Re,pkat,e, eat ISk 7 NI C.o^c � t 1,..1 V e.,...)c4i cAI;44. t►.u1,114.- 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, fetur receipt requested, to the following address: 7h?L z lJc / The depositing of said notice o 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)days after the day of completion. This permit shall inure 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 day of ,200_. By: ' ' In e , // Property or er (to be signed in presence of the No . ) STATE OF FLORIDA COUNTY OF DUVAL On this cic day of f -Q h rc r , ol'6 personally appeared before me, a Notary Public in and for said County and State, /O-r f' l'L , the property owner of I a s e,Jv l3.La!c.“ Oa. , Atlantic Beach, Florida, known to me to be the person(s) described in and who executed the foregoing instrument; who acknowledged to me that he or she executed the same freely and voluntarily and for the uses and purposes therein mentioned. " MIRIAM GRIFFIN ) d � -p°u Notary Public,State of Florida ..mac a A' o er Public in fo . • County za d State Commissiontt FF 163906 11-1' My comm.expires Oct.14,2018 CITY OF ATLANTIC BEACH,FLORIDA, a municipal corporation: Approved: F ?7 vle-.i`— r4 F.TI _ - - - - ,Public Works Director For Permits here ci sidewalk is impacted, Fo city City Manager approval required: Jim Hanson,City Manager Page 2 of 2 710 Selva Lakes Cir - Google Maps Page 1 of 1 Google Maps 710 Selva Lakes Cir lik N IL 494"art r r• , Le ._. - V III1Ptlia ,, Google Image capture:Mar 2011 0 2016 Google Atlantic Beach,Florida Street View-Mar 2011 https://www.google.com/maps/@30.3332668,-81.4053197,3a,75y,28.24h,81.... 2/9/2016