227 BEACH AVE - FOR CO .;s sire City of Atlantic Beach
r kl Building Department APPLICATION NUMBER
WO,•• f (. ��ri,� (To be assigned by the Building Department.)
800 Seminole Road
��� r Atlantic Beach, Florida 32233-5445 �F 2 �, 2i)is 4 w - c.3
Phone(904)247-5826 • Fax(904)247-5$ 5
ay)
i E-mail: building-dept@coab.us I_
City web-site: http://www.coab.ulf3Y: Date routed: 2
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APPLICATION REVIEW AND TRACKING FORM
Property Address: 227 . Bt Q.ci 711rL Department review required Yes No
�
/� Building
Applicant: / 1' ►6i li...5 Ocrincr-re Planning &Zoning
Tree Administrator
Project: , Public Works
-ubDc U ilities
O Public Safety
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: roved. ❑Denied. C O.(Circle one.) pre' I
Comments:
BUILDING
PLANNING &ZONING /
Reviewed by: `�.�.. / 2 Date: Z /id/ 6
TREE ADMIN.
Second Review: ['Approved 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:
tevised 07/27/10
i
I
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 lefty
by Atlantic Beach, Florida, a municipal corporation or anized and e of 2eof
Florida, hereinafter referred to as "CITY" and g g under the laws e e State a,
hereinafter referred to as"USER.".
�' �� e lT/on Pte( 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: Pa04- T)r1
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, retie receipt requested to the following address:
�Z�I eaci 14- /L 4-timq-76 Zde,e -t. 3 223
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) days
after the day of completion. y
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 ublic
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—/q day of Feb rt44i , 204
By: 6Zk.. c,
Property Owner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUPVAL
On this 4Lday of bV(,,t Q r
and for said County , 20 14 personally appeared before me, a Notary Public in
and
1 e said C and Sta e, _ Y J' i C_l c.)6 1 , the
,Atlantic Beach,Florida,known to me to be the person(s)d owner escribed in
and who executed the foregoing instrument; who acknowledged to me that he or she executed the same freel
and voluntarily and for the uses and purposes therein mentioned. y
Notary Public in for said County and State ,
CITY OF ATLANTIC BEACH, FLORIDA, a
municipal corporation:
Approved:
A'o • PAULA F.ALLEM
1‘ S-L. Nor Public-Stag of Florida
/Nr%Linn Ofg. Corms.to*If 51 201x!
Doug Layton,Public Works Director ;; Canmts�lon o9ts7o
,�....:..,� Bonded Through Wtioial Nary Assn.
For Permits where city sidewalk is impacted,
City Manager approval required:
Nelson Van Liere, City Manager
Page 2 of 2
City of Atlantic Beach
Example Site Impervious Calculation
Existing-Include all hard covered ground:
Item Length/Feet Width/Feet Area/Square
Feet
Main Body of House 50 _ 50 _ 2,500
Additional House 20 20 400
Driveway 20 10 200
Sidewalk 20 3 _ 60
Patio 10 40 400
Out Building 10 10 100
Total Impervious- 3,660
Existing
Total Lot Size: Length x Width:
Example: 100 FT x 75 FT= 7,500 SF
% Impervious Existing: Existing Impervious (SF)/Total Lot Size(SF):
Example: 3660 SF/7,500 SF =48.8%
New-Include all hard covered ground:
Item Length/Feet Width/Feet Area/Square
Feet
Main Body of House 100 50 5,000
Additional House 20 20 400
Driveway(50% paver 20 20 200 (50%)
credit
_ 100
Sidewalk 25 3 -
60 _
Patio/deck 10 40 400
Pool- 0 —
__ `_Total Impervious-New 5,960
% Impervious New: New Impervious(SF)/Total Lot Size(SF):
Example: 5,960 S117,500 SF = 79.5%