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1640 BEACH AVE ROW PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD 2_4 ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 RIGHT OF WAY PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOBINFORMATION: Job ID: 16-ROW-1 281 Job Type: RIGHT-OF-WAY PERMIT Description: REMOVE EXISTING PAVERS AND ADD NEW WALKWAY PAVERS Estimated Value: Issue Date: 6/15/2016 Expiration Date: 12/12/2016 PROPERTY ADDRESS: Address: 1640 BEACH AVE RE Number: 169540-0010 PROPERTYOWNER: Name: PLATOCK, BRIAN T& LESLIE G, Address: 1640 BEACH AVE PERMIT INFORMATION: PUBLIC WORKS: UTILITY DEPT.: 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. 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. FEES: PAP111119effigWOVED, ONLY W ACCORDANCE 1*40.QL CITY OF ATLANTIC BEACH ORDWAfiCES AND THE FLORIDA BUILDENG CODES. AML CITY OF ATLANTIC BEACH 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. City of Atlantic Beach -Building-Department 800 Seminole Road Atlantic Beach, Florida 3223M445 Phone(904)247-5826 - Fax(904) 8 E-mail: buddIn0ept@coa1b.us City web-site: http://�.coab.us of sp, APPLICATION REVIEW AND TRACKING FORM '21�`* �44*SL� _"W� "FJ 247-684� PrOPGrtY Address: IG4Q L�)EAQ_tj AV De artment review required Yes No Applicant: Building Planning&Zoning Project: P)P'vc'�?s' ub ic We s ublic Utilities Pu tic a ty Fire Se, rces Review fee Dept Signature Other Agency Review or Permit Required Review or Receipt Florida Dept.of Environmental Protection Of Permit Verified 13 Date Florda Dept. of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco APPLI—'—'--- Reviewing Department First Review: WApproved. DDenied. (Circle one.) Comments: Jet AWk/ BUILDING PLANNING &ZONING Reviewed by: 1-44A9�'g' Date TREEADMIN. Second.Review: L]ApProved as revised ODem/ _17� PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by:�-Date,— FIRE SERVICES Third Review. DAPproveclas revised. oDenied. Comments: Reviewed by: Date: Ised 05114/09 City of Atlantic Beach -Building Department 800 Seminole Road Atlantic Beach, Florida 32233 5 Phone(904)247-5826 Fax(z 5845 #n', 0, E-mail: bwldmg-dept@coab.us Cityweb-site: htip://�.coabms APPLICATION REVIEW AND TRACKING FORM Property Address: P(V De artirnent n3vIeW required Yes No Building Applicant: C) \,&I Planning &Zoning Project: P, . Ir 2 Administrator ublic;Wo s u br, lie Uti ities Pu c Safety Fire Services 77 Review fee Dept Signature 2!5�A,� Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept. of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Amy Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. ElDenied. (Circle one.) Comments: BUILDING PLANNING &ZONING R..i.vvM hv- ck Date: TREEADMIN. Second Review: ElApproved as revised. DDented. 1111111C 17VORK Comments: US 'C TI 11 'IES P;LIC�fi�gk Reviewed by:-Date FIRE SERVICES Third Review: []Approved as revised. DDenied. Comments: Reviewed by: Date*- R.vl..d 0611[4/09 CITY OF ATLANTIC BEACH Row - I ze> CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EAS MENTS 800 Senninde Road 1W Atlantic Bea�h,Flond.32233-5445 904-247-5800 Fax 904-247 5845 PLEASE SUBMIT(2)COMPLETE SETS OF PLANS WITH APPLICATION. [:IT# PERM SBY Y Date ISSUE: THE CIT�_ Job Address—Aya (S-ea-,�, dis E-mail 64,77�c Permitse:_ Telephone# 205�-9?3 - 7066 Permitee Address: 16clo Ige-,Fck lq-c-e Requesting Permission to Construct: Location: (Reference to Cross-Street) &-f- d-- _04 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 ( N Date: Bell South Telephone Company Yes Date: Yes( Ferrell Gas No Date, Comcast Yes No(-I 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, wines, 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 64�eo,�O- (Contractors Project Superintendent) located at —Telephone#: 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 Riaht 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 revie_&0_ w 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. ANN, TONGINMEIPIERGER OWNER P! MYCOWASSION#FFMa6l EXPIRES:afterfi,ma I Signed, Date DEE=n��Nbkft.. o of lon ,4 xft� (12 day f in the o f Duval, tat Florida, nas personally arppeared I M W Note P blic at Large, State of Florida, County of Duval. My isslon ex3i. 8 res: ersonally Known: 7 - Produced Identification: Revised 7129115 Permit Attachment of for Permit# inued .20—Atlantic Beach,FL 32233 Owner's Name: Property Address: R.E.#: Subdivision: Lot#/Block M REVOCABLE ENCROACEMENT PERMIrr TEILS REVOCABLE ENCROACMIENT PERMrr,issued on this—day of.20� by Atlantic Beach, Florida, a municipal corporati.on organized xisting under the laws of the State of Florida, hereinafter referred to as "CnY' and z&;, of Atlantic Beach, Florida, hereinafter referred to as"USER7. VVITNESSETH: That the CrTY does hereby grant the USER permission on a revocable basis as described berem die 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/EaSetamt Permit numbers;noted above(copies attached). This work is generally described as:—e**fi:,.I O � eAl�b4-5 il U� N'—Xf Any facility marmarned, repaired, crected, and/or rastalled in the exercise of the privilege granted remains subject to relocation or removal on thirty(30)days notice by C= to the USER, mid notice to USER shall be given by certified mad, return receipt requested, to the following address: A�40 de�'A 0%-', The depositing of said notice of cancellation in the United States =if shall constitute the notice of cancellation and the burden is upon USER to keep the CfFY informed of USER's proper address. The USER shall promptly make my and all necessary mpairs to my facility crected 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 CrFY or the City's approved representative or other franchised utility to enter upon the above-described property of the CIIY, 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 Crry 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 we and code requirements of the C=, 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 my changes from the approved plans and/or method, must obtain written approval from the City of Atlantic Beach,Public Works Departmenat,for said change. The USER shall,atthe 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, Rod 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 we limitations/requiremcarts of public rights-of-way and other public land. USER fiarther agrees that the CITY and its officers and employees shall be saved harraless by the USER from my of the work herein order the terms of this permit and that all of said liabilities are hereby assumed by the USER, DATED and SIGNED this day of �2Sh &.212 !e M By: RGER W 'djAsn',=W'AV1oN7FF 4MI pe r .I, t 2 EXPIRES 01W6,202 (to be signed in presence of the Notary) [ STATE OF FLORIDA Co OF DUVAL 20 onally appe on own to this of 201 ��onhafty appeared before me, a Notary Public in an for said ty and State, the property owner of Alantic,Beach,Florida,known to me to be the person(s)described in cut. from t'. a . t t Fhfo2 f trumem;wto atknowledgd ht�o an o executed tdhe 9 ' me that he or she executed the same freely and voluntarily and for the uses and purposes therein mentioned. Notary Public in for said Comfy and State , CITY OF ATLANTIC BEACH, FLORIDA, a mumacapal corporation: Approved: Kayle Moore,Public Works Director For Permits where city sidewalk is impacted, City Manager approval required: Nelson Van UM-1 City—M�g- Page 2 of2 MAP SHQ�IIG POE a or� ANOLOLA�D hP ILOO' .4�L.SW�LEtqr 11v%ZCVO8"V8OP9DUVAL MUM. FLORUW SO PART BENO Xon.PMM�WU.�'.Y USFMW,�'. X AT THE MfHff 0 yOLW": FOR h POW OP REFEEEHM MWID 6 A DIST NO F NORTHERLY ALONO THE ENSTSMY ME 0 WM A 8MN`NWG; YNEN 0 A ME mO N W=OR Amou YO CE NON�Eny AWNGYWD O"T W!7ZI vF=YAAWn`UT ON MCM=y RIGHT-Or-wh ON WOO'. ,U (Dzscimms FuRNMED EY wnm MOWMD TO: DEW T. & LESUE U. PIATOCK/ WAOROW� MOMOACE CoRpOnTION/ 05BACHER & SCHNEIDER. p L/ AWORNZYW TITLE WSURANCE FUM f �m DEWEES AANUE CONWk NN Ir P0015' 'O'E —Es) No MVAVW (1�a4) I 5226'(ACT.) Ru m N.G.% OA� OF dO 's w P STORY FRAM LOT RESIDEN LOT a ADDRESS 1 1640 FFE(13 N "%Yl 1 71' k PONT Of BE IN ONG %I tk E REMAINUO PORTQNS OF LOTS 8 & 9 NOT PART OF THIS SURVEY R*23T.Ow ! I � mw Tm-37.12! I W K �NS Wl M NOT O"O'N WMNCS ON FW M WNNN ON ONO�W W K FOUND 'Um ON�co�. UNOVIGNalm�wm HOT Uvm NN..=.'_._=NNNl To ALL AMERICAN SURVEYORS OF FLORIDA, INC. RESPONV8LE - �� 1 7P .1.11-1 �T EHNN�ORS A IM �Zh - fl Tlit�_ fii I iN 13 z z m ME 0 0 'M 0 11H x M M z m 0 22 m m z 0 m z