2279 SEMINOLE RD PAVING PRIVATE STREET �S \ CITY OF ATLANTIC BEACH
r' s)
800 SEMINOLE ROAD
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: 16- ROW -1090
Job Type: RIGHT -OF -WAY PERMIT
Description: asphalt for records only
Estimated Value:
Issue Date: 5/10/2016
Expiration Date: 11/6/2016
PROPERTY ADDRESS:
Address: 2279 SEMINOLE RD IRRG
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: PREFERRED MATERIALS, INC
Address: 11482 Columbia Park DR W STE 3
Phone: 904 - 288 -6300
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
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PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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" $ sue " CITY OF ATLANTIC BEACH
;3.,,, 1 CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
/ 800 Seminole Road 904 - 247 -5800
u1tir)% Atlantic Beach, Florida 32233 -5445 Fax 904- 247 -5845
PLEASE SUBMIT (2) COMPLETE SETS OF PLANS WITH APPLICATION. PERMIT#
Date 1 it C-I3 U 20 1 (D ISSUES BY THE CITY
Job Address QA 7 95i ) r l C /rte /al. 34;(' 9 E -mail S -'F% J rC (�f
Permitee: U -fer tott l p C (t TO (1) C-1 Telephone # 90 /- 70 ?" .- 36 6 9
Permitee Address: 79 S'rn/1CIt' SI, Ow iii-tc ,fiecch FI 3-9 .3<-
Requesting Permission to Construct: ;'tt ev rk pr, pi ( itdoaj _ 1 ?- r`cati DUnPS
Location: (Reference to Cross - Street) �7c S ai Q <.- +) n �Pi : � f -' ` 00 le tea „
1. Applicant declares that prior to filing this application he has ascertained the location of all exis
ri utilities, both d
aerial and underground and the accurate locations are shown on the sketches.
As-pildr -1. 0)17
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 Permitee unless reimbursement is authorized.
3. All work shall meet City of Atlantic Beach or Florida epartment of Trans ortation Standards and be performed
under the supervision of � /I ; e Vic krey F IN; rtt/ ki( ractor's Project Superintendent)
located at /IzffS2(t tv q.,(C % r ix: } n:)..9.6 Telephone #: `)Ci-( -5 - 5 1
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 . 0 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.
, sY PL_ Notary Public State of Florida
Shirley L Graham
OWNER €y Commission FF 086990
e
q(_ k.et .D Signed: r C •ate: - 2 61 flay
of in the Co of Duval, State Of Florida, has personally appeared l
....r.11111. A Notary Public at Large, State of Florida, County of Duval. My
cow' issior •xpi ��!
� � air Personally Known:
y • Produced Identification:
Revised 7/29/15
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