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870 MAIN ST - ROW -JEA POLE :"js r v ‘ CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD J r: 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-1040 Job Type: RIGHT-OF-WAY PERMIT Description: JEA POLE Estimated Value: Issue Date: 5/16/2016 Expiration Date: 11/12/2016 PROPERTY ADDRESS: Address: 870 MAIN ST RE Number: None PERMIT INFORMATION: PUBLIC WORKS: All silt must remain on-site during construction. Full right-of-way restoration, including sod, is required. FEES: Total Payments: $0.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BIIILDING CODES. .-0,1 J; City of Atlantic Beach _ APPLICATION NUMBER % Building Department 1 �ZEC:-.I. T-gD (To be assigned by the Building Department.) 2 800 Seminole Road � Atlantic Beach, Florida 32233-5445 ' MAY 0 6 ZOtb /(p- 44() - /0. Phone(904)247-5826 • Fax(904)247-5845 '401119 E-mail: building-dept @coab.us 113Y: Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ('7 /////h /V c Department review required Yes No Building Applicant: ai� Planning &Zoning Tree Administrator Project: ;j ;: ii 'Po , Public Wor' • . Public Safety Fire Services Review fee $ Dept Signature I 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: APPLI TION STATUS Reviewing Department I First Review: Approved. ❑Denied. (Circle one.) Comments: 5 -AdiFF17' ui r1� � r`1 BUILDING ) PLANNING &ZONING r �--- Reviewed by: � Date: ! 3/e TREE ADMIN. Second Review: A roved as revised. ❑ pp ['Denied. ' ;al< IC WO S Comments: UBL`IC UTILITIES . -6 PUBLIC IC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. Comments: Reviewed by: Date: Revised 05/14/09 CITY OF ATLANTIC BEACH , T CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS _- 800 Seminole Road 904-247-5800 . Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 PLEASE SUBMIT(3)COMPLETE/SETS�OF PLANS WITH APPLICATION. Date Or 7C 1f,-) 3 , 7'v 1 6 PERMIT# S ISSUED BY THE CITY Job Address , /(_,J /'(,64,-7 Permitee: TIC 4 Telephone# Permittee Address: Z I (1/P4' C.-76-+'l,C-7 Requesting Permission to Construct: (l ) 4 61,:,c L/ , ..-6u',y )-7,- k , ii..? y-> rel.,- 0//' c1, ,.• t 2 ,k 1.9 t1 3 S i"7ei 4, ,cr. Location: (Reference to Cross-Street) / .S1._ Cv/ 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( ) 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 Beach or/Florida Department of Transportation Standards and be `, 1,.,.7 (Contractor's Project performed under the supervision of i� Superintendent)located at 7 ,/ l.V'S> l h,L-,‘�1 )�iA(<< Telephone#:-C'G > 2?i> 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 (-C days. If the beginning date is I 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 i Signed: Date: Before me this day of in the County of Duval, State Of Florida,has personally appeared Notary Public at Large,State of Florida,County of Duval. 01 My commission expires: Personally Known: Produced Identification: ENGINEERING DESIGN ORACLE PERMIT MAXIMO DATE REL PROJECT#: 17690 N.O.: 8003205 WO#: 23642023 __ CONST:05106/2016 CIR. TREE TRIMMING SUB-STA NEPTUNE BEACH 17690 . N.O.: 561 REQ'D:YES CELL ENGINEER: Robert Simpson _ N.O.: N/A ZIP CODE: N/A CUSTOMER/ SVC PHONE LOCATION: 860 MAIN ST./POLE INSTALLATION 561 CENTER: SSSC N.O.:665-7793 r r' e '6 • l i t �*G�I - -g 990 STA 1, P# 8160 MAIN ST./ INSTALL 35/4W FOR ,��, 2 FUTURE HOME. RUN 2/OP TO STA 2. ,�_ _ / a °g. o • A~-,/d 935 - STA 2, P# 835 MAIN ST. �..�56 F .1. r o\ OM_ a,, tea; TREE TRIMMING REQUIRED I o v • o v t- THIS GOES WITH PERMIT # 2016/00765.910 I / ♦S' c. C 924 Q TREE TRIMMING REQUIRED. 25B (n ! en • o o F '� i Z1 E- Fs ® o O 1 480 Q I 439 I I I • sg • o ci * I 1/07 OD O • 2/OP l'1-i �t to ; -- 90\ --- - __ - _ I 30T J, - - �.l 9TH ST C_- 2io? - - - I - --------- - - - - -- -� • I ► m — _ STA 2 I I - T CC pc°uture Service 1/0T I I is • I f` a Y • STA 1 I — 5 ♦x x 520 c �'� O I g5B a ° o ! t--... "t0 l''�\ 1 \p •MM 806 -� ,t I x oC x ti c 2 5 w,� ,n• x oC a OC ® !\moo °xocc x I a NNN\ co ® Cr) I °� x°C a I ° •ate C 46' 506 78 `...C? o N. °C CV 15 25B °' 795 • r g 4 � o 0 748 t' ! \ N• ° ° 25B ®o 702 a )SR M.N a !!I b'‘ o• I 790 25B 7 6..PVC WM • ..b MH-A-893 9TH ST 1► ' Mate A I 85 , v.. IF ot.i- p,-/, City of Atlantic Beach APPLICATION NUMBER �s ? Building Department (To be assigned by the Building Department.) sss 9 Y 9 p ) r � ``,. 800 Seminole Road Jew Beach, Florida 32233-5445 I /O- 4o - Apthlantic one(904)247 5826 Fax(904)247-8845 mtiIAY Q 5 2016 --„of31.0 E-mail: building-dept @coab.us Y Date routed: f�// . City web-site: http://www.coab.us . . v- APPLICATION REVIEW AND TRACKING FORM Property Address: (!7d 4?/9' N c Department review required Yes No Building Applicant: _ r Planning &Zoning Tree Administrator Project: 1J 1 Public Wor Cgublic Uti 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: VlApproved. ['Denied. (Circle one.) Comments: ✓GL 4veltej 42,ftn q/ 1 BUILDING PLANNING &ZONING y ,` - A9)/Reviewed by: ��� Date: 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: 'devised 05/14/09 • `J"�` CITY OF ATLANTIC BEACH i� l , CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS /j 800 Seminole Road 904-247-5800 L__,__;___I/%/ Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 PLEASE SUBMIT(3)COMPLETE SETS G/,OF PLANS WITH APPLICATION. Date / I fit(� 3 / (/D I 6 PERMIT# Job Address ' '20 / -( 4-? S ISSUED BY THE CITY Permitee: 4 / / Telephone# Permittee Address: al (Ale I- &vc..G, ��'/ Requesting Permission to Construct: 6 ) S Li,.,..ss C1 ,A.drdyi pi9te /'u I-) ,iv 061 Location: (Reference to Cross-Street) ! :S_/: (4/, 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( ) 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 Beach ornnFlor da Department of Transportation Standards and be performed under the supervision of /G. 5,i, .p`6°h (Contractor's Project ./ Superintendent)located at 7 west (h,,,%.t1 S' . J,-i(// Telephone#: 6o5 7?' s 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 60 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 • Signed: Date: Before me this day of in the County of Duval, State Of Florida,has personally appeared Notary Public at Large,State of Florida,County of Duval. I My commission expires: Personally Known: I Produced Identification: ENGINEERING DESIGN ORACLE PERMIT MAXIMO DATE REL PROJECT#: 17690 N.0: 8003205 WO#: 23642023 CONST:05/06/2016 CIR. TREE TRIMMING SUB-STA NEPTUNE BEACH 17690 I N.O.: 561 REQ'D:YES ENGINEER: Robert Simpson CELL _ N.O.: NIA ZIP CODE: N!A CUSTOMER' L SVC OCATION: 860 MAIN ST./POLE INSTALLATION 561 CENTER: SSSC P N 0.-6657793 Ni STA 1, P# 860 MAIN ST./ INSTALL 35/4W FOR 29�980�Q FUTURE HOME. RUN 2 10P TO STA 2. _ a • � • �� STA 2, P# 835 MAIN ST. G 935 TREE - •°c ��. TRIMMING REQUIRED 0 I THIS GOES WITH PERMIT # 2016/00765.910 ~ ms `r e ° i Q TREE TRIMMING REQUIRED. ! I- 924 :1 I— 25B rt C ° zi • 480 Q I ~ cv • j 43 7 • tn Q CO �` I 1/0T 0 o 2/OP `rtr' 902 ---- ------- • 9TH ST = 0 2/0P i l jco of I — STA2 =uture Service 0 ' I 1/OT I T 0C x e e 0'0 STA 1 i —v-, ry ox 520 o I' I C 0 835 o i o 25B o ♦ IpP 806 ---) Q. ^vl C • I �OC CI.CC � I 00 00 -- N I o (n I ,- O O rn r ° - -�� °� ppOO° a I a ®crn c e 884 781 - j r.--s cc 50B c� 0 25B °' 795 _ o ■ /� •h o e o • 50B ~ oo 0 748 j o ° ■ -- 25B ' N..\106 •O� a I o0 702 I N■ 790 h- ?SR I 1;` r-, CI i I rn 25B 4,_.