599 CLIPPERSHIP LN - RIGHT OF WAY - 03 CITY OF ATLANTIC BEACH
r ik j 800 SEMINOLE ROAD
J R XATLANTIC 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-1529
Job Type: RIGHT-OF-WAY PERMIT
Description: REMOVE EXISTING CONCRETE DRIVEWAY AND WALK
WAY, REPLACE WITH PAVERS
Estimated Value:
Issue Date: 7/15/2016
Expiration Date: 1/11/2017
PROPERTY ADDRESS:
Address: 599 CLIPPERSHIP LN
RE Number: 170703-0214
PROPERTY OWNER:
Name: HASTEDE ET AL, WILLIAM A
Address: 599 CLIPPER SHIP LN 599 CLIPPER SHIP LANE
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:
PERMIT IS APPROVED ONLY IN ACCORD%NCI.: WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
r�" CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
r�Jl�l�!'
Fence/ROW $35.00
Total Payments: $35.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
etvtor, City of Atlantic Beach .--.. APPLICATION NUMBER
400- BuildingDepartment ��� !
(To be assigned by the Building Department.)
it 800 Seminole Road
aJ10V s• Atlantic Beach, Florida 32233-5445 JUL 0 7 as f4/ 1 Co` IROV\1 -15 Z`
Phone(904)247-5826 • Fax(904) 5845 /
�1;519' E-mail: building-dept@coab.us BY* Date routed: 7/ `7//
City web-site: http://www.coab.us (((
APPLICATION REVIEW AND TRACKING FORM
JProperty Address: S�gCLL PS � P CU Department review required Yes No
Building
Applicant: 0 Ll. E j _.• Planning &Zoning
p Tree Administrator
Project: ? PLACE COC (tee- _ ublic o •
,, 1 'Ub is
f RkV E-Ali. y °�' V.) Au L t'rt+ Pubic _ -
pv - C\/ Fire Services
Review fee $ 2a� 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:
APPL ATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING --7/5"
Reviewed by: - Date:
TREE ADMIN. Second Review: A roved as revised.
❑ pp ['Denied.
'P j C WORComments:
0. :LI UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
Aolimik City of Atlantic Beach
Building Department AP--PLICATION NUMBER
(To be assigned by the Building Department.)
800 Seminole Road
u� �r Atlantic Beach, Florida 32233 5445 JUL 0 7 2016 I n 10 - (�CSw _( � 'Zc)
Phone(904)247-5826 • Fax(904)247 45
'Pt 0109Y- E-mail: building-dept@coab.us BY: Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 5 79 CLI pp t p Liu Department review required Yes No
Building
Applicant: 0 LA) k) -Z, Planning &Zoning
Tree Administrator
Project: RE3 p L A C C o
` ub is 'line
RA l) E-W• -y `'- \k) R u,,c L [(&f Public-safety
VE- 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:
BUILDING Jae t �G
PLANNING &ZONING �/ 7/3/2G
Reviewed by: iG�W Date:
TREE ADMIN. Second Review: QApproved as revised. ❑De ed.
PUBLIC WORKS Comments:
PU IC LIT
U IC A E Reviewed by: Date:
FIRE SERVICES Third Review: QApproved as revised. []Denied.Comments:
Reviewed by: Date:
tevised 05/14/09
I
r`yA1'`''` CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND-_EASEM.ENIS _______
800 Seminole Road
904-247-5800
.ussii, Atlantic Beach,Florida 32233-5445 Fax 904-247-5845
PLEASE SUBMIT(2)COMPLETE SETS OF PLANS WITH APPLICATION. PERMIT# 1(.0— ROW -'S zel
Date 6 _ 3 0 - /6 ISSUES BY THE CITY
Job Address 2 t-lr fOfer S).,y ,i/�f�a t l tr._ 1� �L E-mail o ed`U` 4 t;1P 0 ci..ci.Ce✓n
Permitee: F,t rj`- ('o,lt )fn;,2r-i)1„LC Telephone# `leg- .sc, -ag/!,/
Permitee Address: 7/1 /off 0-) IUoin�i art, ' FL 3J-a_5 7
Requesting Permission to Construct: J2er'►e✓e ek.;<-1'n5 ce.,c.: 'l' ektsvNutt7)d-e !cCCi' w,/Are-cm et/04- rtade
Location: (Reference to Cross-Street) (U ►fit
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 (X) No ( ) Date: 6 -.363-/ ,
Bell South Telephone Company Yes ( ) No ( ) Date:
Ferrell Gas Yes( ) No( ) Date:
Comcast Yes SjQ No ( ) Date: /r,--30---/6
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 .you. k. S c. ö ' )-y- (Contractor's Project Superintendent)
located at 5-59 CI,` er> 1 p L,1 A4ic,1Y, 14/. Telephone#: c* I•-,Sl5j'; j[yC
4. All materials and equi ent shall be subject to inspectidn 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 S 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.
a L L'i_am_
OWNER ;+� --�i,� '
/W 9 _.lil : wary Public-State o1 Florida
Signed , _ __;�.,, � 017 PC)- 1-
01 day
of Jura e, in the Countyof Duval, State '"" "'�
ersonai eared
1nj l' r t Pc I-{AStede, Notary Public a Large, SrtTe-Z57 o a, u ty of Duval. My
commission expires: Jt.RlLi/ /1Personall Known:
roduced Identificati t r iv ..s 1.4(.2►1SL.
QG4icer1 71')1114 e
__- ---hermit 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,349day of 44/ , 20)
by Atlantic Beach, Florida, a municipal corporation organized and existing under the la*g of the State bf
Florida, hereinafter referred toy 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: fiaJe/i let
h,
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:
-f? C/5; 7 J ‘etc
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 sidewallcs."
Page 1 of 2
A
_ - --The pnor to making any changes from the approved plans-and/or_method,-mu-st-obtaiten
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 .3C day of J rt.t , 2016.
By: I Lj1
Property Owner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this !7t day of VUri.t. , 20Lb, personally appeared before me, a
and for said County and� M�ate Notary Public in
511 C tipper SKr r Lrl ,cH�,�►.i{i��l \nl���;u m R. FFasted� , the property owner of
�p , Atlantic Beach,Florida,known to me to be the person(s)described in
a - • - - -• -• •- • -••••• ••s I ent; who acknowledged to me that he or she executed the same freely
• -Vii �tid pu oses therein mentioned.
.CO;.� Notary Public-State of Florida
�� , My Comm. ion* F 0 4,112017
••.o.os Commission FF 074511
at6/611)2/":41—Mr4-jNo' .
CITY OF ATLANTIC BEACH, FLORIDA, a
municipal corporation:
•
Approv/ed`:
,Publ. Works Director
Dena l t D e bo-vi fz
For Permits where city sidewalk is impacted,
City Manager approval required:
•
Nelson Van Liere, City Manager
Page 2 of 2
_.-o►--• - — --
'l kSi IC111S 1.77 MCS161i
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" } '., ' LOT .1 BLOCK / AS SHOWN ON MAP OF
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