1892 HICKORY LN - DRIVEWAY tri rJv,�
` ....:'4 SA CITY OF ATLANTIC BEACH
r. j 800 SEMINOLE ROAD
J 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-1155
Job Type: DRIVEWAY
Description: REPLACE CONCRETE DRIVEWAY AND SIDEWALK NEW
PAVERS
Estimated Value:
Issue Date: 5/27/2016
Expiration Date: 11/23/2016
PROPERTY ADDRESS:
Address: 1892 HICKORY LN
RE Number: 172020-1306
PROPERTY OWNER:
Name: COVINGTON, LARRY B
Address: 1892 HICKORY LN
GENERAL CONTRACTOR INFORMATION:
Name: CITY STONE, INC.
Address: 11459 PHILLIPS HWY
Phone: - -
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:
fie'tila&RQWROVED ONLY IN ACCORDANCE$&..10011,1, CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
j 1-'-\11-1-,
,,)" ss, CITY OF ATLANTIC BEACH
;�0.� , ;. - Is) 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.
rs1-=>>`�r,�, City of Atlantic Beach '` ECETVEi D APPLICATION NUMBER
ri *. Building Department
�,r ;, , (To be assigned by the Building Department.)
,'i, ,.f 800 Seminole Road MAY 19 2016 /�
�,' :. ,- Atlantic Beach, Florida 32233-5445
I l�J — D w Ay —( C BS
Phone(904)247-5826 • Fax(904)247-5845
�u;sl9 E-mail: building-dept@coab.us Date routed: Si( Pili 69
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 18 9 z L'1 ( C kor L Department review required Yes No
Y ., Building
(i?..t4-(1 Applicant: SOç\ Q.. I „ C Planning &Zoning
Tree Administrator
Project: Y \ eMof e 0 .3 (-1.0,1---ei-e � riT
N e(A) Pove r u. ic SafetI II s�V e W 0.y Public Safety
( Fire Services
Review fee $ 2r- Dept Signature l‘ik .
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 First Review: pproved. DDenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: ij� Date: r(2-4/>ti
TREE ADMIN. Second Review: QApproved as revised. ['Denied.
: WORIK Comments:
:LIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: QApproved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
Ig9z
( i/�
;` °�� CITY OF ATLANTIC BEACH I Ca ^ (\y-L (S S
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
N 400
, •- r'
800 Seminole Road
ussi�� Atlantic Beach,Florida 32233-5445 904-247-5800
Fax 904-247-5845
PLEASE SUBMIT(2)COMPLETE SETS OF PLANS WITH APPLICATION. PERMIT#
Date V S//7//6 ISSUES BY THE CITY
c89Z„..
Job Address .-Wit Y/cKO/zy L/ 7Zg'1/mac• 8C// E-mail SiiLE
Permitee: L/ RP./ CO V/✓VC.job/
Telephone* eit0 1/- 751._Q q 7 6E-7-4
Permitee Address: '? )f16Kf2/C T/ C. c/-
V
i8.9z y 4- �1�f�,I) , �� 3�Z�-33
Requesting Permission to Construct: REPS Y c ceNC 6- 9,211704/fly f-.5-1. t,,,
Ii)LWI L/< Fyk ?Alleles
Location: (Reference to Cross-Street) / ` "I S 1 /
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
Bell South Telephone Company Yes( ) No ( Date:
Ferrell Gas � ( ) No (� Date:
Comcast Yes( ) No( Date:
Yes( ) No (k) 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 Department of Transportation Standards and be performed
under the supervision of Cil,/5 TON l /NC - WLR,/dv&1vN(Contractor's Project Superintendent)
located at '7 53' Ci:.614-711 RJ qft-x 322.57 Telephone*: 00
4. All materials and equipment shall be subject to inspection by the Director of Public Works ors 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,
•
,A�,...........,,b�; assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and
8` �_ all loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder
,vi- '-' •= of the aforesaid rights and privileges.
`.•,,+04...?:�$. The Director of Public Works shall be notified twenty-four(24) hours prior to starting work and again immediately
2 upon completion.
cc,s �e
1 N . o s TWNER
ea 9
�.41 M • c igned: =r . ', Mgr Date: /7 Before me this /
a j ; F �� • .• in th• County .f D val, State Of Florid , haspersonallyappeared
��/ day
,a > HMS ) f C .j 71 �' 0'-No - P blic at Large, State of Florida, County of Duval. My
,,,e, y C' commis'. expir s: ,
"" a � ���5 .�� ._ , �Y �� Personally Known:
Produced Identification:
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
Florida, hereinafter referred to as "CITY" and under the laws of the State of
hereinafter referred to as"USER". 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:
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 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 ,20_.
By:
Property Owner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY rOA DUVAL
On this day of
�a
20ers nall}t appeared before me, a Notary Public in
and or said County and State, r
5� � l,�h f C�p t- ' Atlantic ` e,r-Lad _� , the property owner of
Beach,Florida,known to me to be the person(s)described in
and who executed the foregoinlinstrument; who acknowledged me that he or she executed the same freel
and voluntarily and for the uses and purposes therein mention . y
Notary Public in for said County and State
CITY OF ATLANTIC BEACH, FLORIDA, a
municipal corporation:
=';$•. TONT GINpI ESPEEIGER
Approved: --Oak.14'Yy MY COMMISSION a FF 924951
1':, ��a EXPIRES:October 6,2019
q• aonded Thor Notary Public Underwriters
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
MAP SHOWING SURVEY ' OF
LOT 2, SELVA MARINA UNIT NO. 12-B, AS RECORDED IN PLAT BOOK 36, PAGE 76 OF THE CURRENT
PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. •
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n To: a5T/-a bs 2=4,4.caL T I-4 voo"i-i' 5..r SERvicee5
r City of Atlantic Beach - -TVED APPLICATION NUMBER
Building Department
Y (To be assigned by the Building Department.)
800 Seminole Road ���� /� � c
�� Atlantic Beach, Florida 32233-5445 1 lJ " D�)(n -' -1
Phone(904)247-5826 • Fax(904)247-5845 / -
c;i1>%- E-mail: building-dept@coab.us ��_ Date routed: 5/C P,/I �o
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 8 -I 2' [—I t ko Lk. Department review required Yes No
Y Building
Planning &Zoning
Applicant: Qt4.ii ��p�� ( � C 9
Tree Administrator
Project: Renew:N.6' O R(? e _Public Wor
clic Utilitie
N C,c.J Pcx..Ve!- r l V e W cL y C Public Safety
` c_(, � ��I �l 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: Approved. ['Denied.
(Circle one.) Comments: j'e n a *
BUILDING �/'1�
PLANNING &ZONING `!, ,
Reviewed by: / Date: 52-33
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑D• ied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
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