374 4TH ST DRIVEWAY � r
t-Y It., \ S f CITY OF ATLANTIC BEACH
0 800 SEMINOLE ROAD
J _ lipp) - 1 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
DRIVEWAY PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16 -DWAY -947
Job Type: DRIVEWAY
Description: CONCRETE TO PAVERS
Estimated Value:
Issue Date: 5/2/2016
Expiration Date: 10/29/2016
PROPERTY ADDRESS:
Address: 374 4TH ST
RE Number: 169824 - 0050
PROPERTY OWNER:
Name: RICHARDS, R S
Address: 374 4TH ST j
PERMIT INFORMATION: UTILITY DEPT.: PUBLIC WORKS:
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.
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, Shapell's, Sunshine Recycling and
Waste Pro).
Full right -of -way restoration, including sod, is required.
FEES:
Fence /ROW $35.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
.j r\-iv J,
.� ' `s A CITY OF ATLANTIC BEACH
tixt 800 SEMINOLE ROAD
\ J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
J AJ1i1r r.
Total Payments: $35.00
PERMIT BUILDING IS APPROVED CODES ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
!.
` CITY OF ATLANTIC BEACH
' aim, CONSTRUCTION PERMIT WITHIN CITY RIGHT
i
■ I I 11 aril
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800 Seminole Road i --- '= - -' -- •
art ,%' Atlantic Beach, Florida 32233 -5445 1111) Fax 904 -24 i
PLEASE SUBMIT (2) COMPLETE SETS OF PLANS WITH APPLICATION. i
Date Y'2 -42.' ISSUES BY 1- 1-- TY
3 I Y y th S ,4 L c C i� 3 ��33 _+_ � r
Job Address E -mail r S r h cll. l� Liens *
Permitee: a flievine. -/- A 4424- f- IQ i c d s Telephone # 9 Y - 0771 - O' 10
Permitee Address: Same. ac job a dci, r1 S
Requesting Permission to Construct: D rive W y a w1 pct_vQ re wiUV ii/t �- i4-4-1 a
C O� cre,A-e. CAri veWci y d .,J
Location: (Reference to Cross - Street) )4/p, 0 Vp bei-we eln rc-d" 'oa- 4-- £ lel Dr l v .
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.
(-01,1 � A L_ett�r of Notificatio�} mailed t the following Utilities / Municipalities:
Jacksonville Electric Authority Yes ( No ( ) Date: 6
AA Bell South Telephone Company Yes (V No ( ) Date: 4 l . t2. / @ W \A --- 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 lori • a Department of Transportation Standards and be performed
under the supervision of V • Y''e, L _ ' A• e • (Contractor's Project Superintendent)
located at 1 ' 34 ¢ �/evn f rtes De 3 � . 1 qty elephone #: q 0 y - S ti..- ' 7 . Q to
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 00 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 .r. • • - ; • .4.. 1 mmediately
upon completion.
yr P� Notary b State of Florida
r Shirley L Graham
�, - My Com mission lic FF 086990
OWNER oF«d� Expires 02/14/3018
I
Signed: Date: Z Before me this 'Y',, C.-- day
of • , in the County • .val, State Of Florida, has personally appeared
-� or, Notary Public at Large, State of Florida, County of Duval. My
co"' w " ,.ires: _,L gt. Personally Known:
Produced Identification:
- ..8 -0 Revised 7/29/15
•
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 day of 20_
by Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of the State of
Florida, hereinafter referred to as "CITY" and 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: L ni &E k T1 - PA■qi..0
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) days
after the day of completion.
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 peimit 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 Z2- day of v17- 20
ae
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L.
Property Owner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this Zz day of , (_, , 20 personally appeared before me, a Notary Public in
and for said County nd State,
, the property owner of
, 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
4 00
d ri1y and for uses and purposes therein mentioned.
NO' A L 4
�ttsr Po Notary Public State of Florida
Notary Publi in f . 1 County and State Shirley L Graham
h c u My Commission FF 086990
1 4 ofy ..cP Expires02 /14/2018
CITY OF ATLANTIC BEACH, FLORIDA, a
municipal corporation:
Approved:
Kayle Moore, Public Works Director
For Permits where city sidewalk is impacted,
City Manager approval required:
Nelson Van Liere, City Manager
Page 2 of 2
We send this email on 4/22/16
Email 1 r
* Name Rob Richards
* Service Address 374 4th St. Atlantic Beach, Fl. 32233
JEA Account Number (required for billing
questions) 1 51 041 4200
* Email Address rsricha@bellsouth.net
* Phone Number 904 - 571 -2773
* Select a Category
- select a category -
Payment Extension & Arrangements
Payment Offices & Locations
Billing & Payment Questions
Electric & Water Quality
Energy Efficiency & Audits
Website Errors & Suggestions
General & Other Inquiries
* Question or Comment We wish to remove our existing concrete
driveway and replace it with pavers. Do we need to get an easement
4 agreement from you before we get our permit from the city of Atlantic
Beach?
MAP SHOWING BOUNDARY SURVEY OF
/ (1457 %Z DA CDT Z 7 BLOCK 5 AS SHOWN ON MAP OF
$L/$,D /VisiDiC/ "4 4 TL41/T /C \ ,BE,4
AS RECORDED IN PLAT BOOK 5 PAGES 410.7 OF THE CURRENT PUBLIC RECORDS OF DUVAL CO., FLA.
FOR eplEOr `S 4 1A7;,' /'1E ,4,JI/ ,2 /CrygeOS
NOTE BEARINGS SHOWN HEREON ARE BASED ON THE ABOVE MENTIONED PLAT.
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APPLICATION NUMBER
S�Lyf Cit of Atlantic Beach � ' EI V ED (To be assigned by the Building Department.)
r De artment 1 9 7
S : k v Building p APR 2 2X016 1��J/�
r . i ` Atlantic B eac R F a d
'- sl Atlantic Beach, Florida Fax (904 8A45
PR
Phone (904) 247 5826 Fax (904)? Date routed: IMMIX'," � , E -mail: building-dept@coab.us
�J;il�
City web -site: http: / /www.coab.u
APPLICA TION REVIEW AND TRACKING FORM
TH
1 _ Department review required � No
o
Property Address. Building _-
' "� ff Planning & Zoning -
o W Tree Administrator _-
Applicant: Ds J ' /[� _
- L � r � RIG�� �•�'N --
Project: _ _�
Pus is - ` _-
Review fee $ Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required of Permit Verified By
Florida Dept. of Environmental Protection IIIIIIIIIIIIII
Florida Dept. of Transportation IIIIIIIIIIIIIIIINIIIIIII
St. Johns River Water Management District IIIIIIIII IIIIIIMINIIIIIII
Army Corps of Engineers
Division of Hotels and Restaurants ■
Division of Alcoholic Beverages and Tobacco IIINNNIIINIIOIIIINIII
Other:
APPLICATION STATUS
First Review: A pproved.
❑Denied.
Reviewing Department / _�� (L
(Circle one.) Comments: JG.e 444,611 Q :ir BUILDING `
Date: Amewl•Ki•
PLANNING & ZONING Reviewed by'
TREE ADMIN.
Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES Date:
Reviewed by:
PUBLIC SAFETY Denied.
FIRE SERVICES
Third Review: ❑Approved as revised. ❑
Comments:
Date:
Reviewed by:
Revised 05/14/09
`� " _ j\ Building Department
j , ,Ly - � City of Atlantic Beach 0+��T �/ >� APPLICATION NUMBER
.4 (To be assigned by the Building Department.)
r qPR 2 �
_ `r 800 Seminole Road
Atlantic Beach, Flo 32233 -54 2 2 0 j6 6 �� t . 9 7
Phone (904) 247 -5826 • Fax (90 - : 845 Date routed: /
0111 . E -mail: building-dept@coab.us
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
TH
Department review required Yes No
Property Address: Building _ -
Q tO 7) Planning & Zoning _ -
Applicant: /1 •� �1 Tree Administrator _-
Project: �/ G C " U R ft f c Work s
Pu•ic - T --
Review fee $
Z'r Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required of Permit Verified B
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 IININIIIINIIIMINII
Other:
APPL • ATION STATUS
Reviewing Department First Review: (%Approved.
Denied.
(Circle one.) Comments: /
BUILDING / (,j / �
W ate: tt I
PLANNING & ZONING Reviewed by:
TREE ADMIN.
Second Review: ❑Approved as revised. ❑Denied.
-1 oRKS Comments:
, 4. UTI ITIE S Date:
Reviewed by:
p LIC S FETY
FIRE SERVICES Third Review:
Approved as revised. ❑Denied.
Comments:
Date:
Reviewed by:
Revised 05/14/09