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200 AQUATIC DR - RIGHT OF WAY S yV1- ' '\ , CITY OF ATLANTIC BEACH '""" •• 1J 800 SEMINOLE ROAD Ai, 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: 17-ROW-3657 Job Type: RIGHT-OF-WAY PERMIT Description: ATT to place 20' of fiber cable via trench method and 572' of aerial fiber cable on existing pole line. Job#73E68196N Estimated Value: Issue Date: 4/13/2017 Expiration Date: 10/10/2017 PROPERTY ADDRESS: Address: 200 AQUATIC DR RE Number: None PROPERTY OWNER: Name: CITY OF ATLANTIC BEACH Address: 800 SEMINOLE RD PERMIT INFORMATION: UTILITY DEPT.: PUBLIC WORKS: See attached Utility Map. All runoff must remain on-site during construction. Full right-of-way restoration, including sod, is required. Must replace all sidewalk and/or roadway damaged by construction. FEES: Total Payments: $0.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORID k BUILDING CODES. ,,S�.Lyr,�, City of Atlantic Beach APPLICATION NUMBER �4 ,!- s� Building Department (To be assigned by the Building Department.) 800 Seminole Road17,g„AJ2657 v- x Atlantic Beach, Florida 32233-5445 Ap u42011JPhone(904)247-5826 • Fax(904)fiECEIVI 7-5845 J;3 9r E-mail: building-dept@coab.us Date routed: LI-3-I-] City web-site: http://www.coab.us BY: APPLICATION REVIEW AND TRACKING FORM W-an ocC4�c.`vlo(lbl c,. S CAA .91„,(>2"4'tDimirk. i&>cxk- A Property Address: 9)00 I _Ant -- Department review required Yes No Building Applicant: Oar,61o, Cor -'rib- 'o*-p rA- —I) Planning &Zoning Tree Administrator ; �- i b-� Project: Ste+({ �r,�r�•� 64 aP rta .( c,�\ � ir.7.� 'ublic tilities al-eKn*( 11 ��. Public Safety Cvn 0 o/*cpm z. 1'Q , Ce !;y(rIevir- eln( `' f)t-1?�Sft 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: [pproved. ❑Denied. a //f - (Circle one.) Comments: ,lee i#16.41/, C00#/ BUILDING PLANNING &ZONING Reviewed by: Date: Y/c)/l? TREE ADMIN. Second Review: ❑Approved as revised. ❑D ied. LIC 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 I ;, tAPJrjJ, City of Atlantic Beach APPLICATION NUMBER `61 , • Building Department EC E IV E (To be assigned by the Building Department.) - _ , - 800 Seminole Road.� ;, Atlantic Beach, Florida 32233-5445 �pp� 7—gad() Phone(904)247-5826 • Fax(904) -5858 U 4 2017 "za;i,l9r E-mail: building-dept@coab.us Date routed: 0-17 City web-site: http://www.coab.us By: APPLICATION REVIEW AND TRACKING FORM a { `c.g1acQ&QSS,. i1 S.(-L�\1(�eu A .* 6n o ,,pew.+`b1ota - o - hal Sale Property Address: a00 AtLA6t-kr, Department reView required Yes No Building Applicant: he___«o. (oma,{ fiZ(0,-p (r� - 0 Planning &Zoning rt Tree Administrator Project: 5 ttt, (( � . c< 421y2V a a r�,4(-p atiyCs u lic Wor on-eXnb`nit pd-c. ublic tilities Public Safety -Ui'l4rx -k- - 'o l‘k-~i\nez, C e anew- ,pri''c�)(J/f St* Fire Services g 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: APP ATION STATUS Reviewing Department First Review: Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: 74'I Date: lb ( 7 TREE •DMIN. Second Reviroved ew: A ❑ pp as revised. ❑Denied. P. ti01 :/VORKS encs: 'UBLI TI MLR.. -- 7 i PUB IC S•FET Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 i �,. CITY OF ATLANTIC BEACH „ P 2, J; _- A CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS ` ��. 800 Seminole Road 904-247-5800 ' T11 Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION. Date D 3 ,2-9/?A 17 PERMITD B (1-gat)-3657 O49 A"Z.✓�� ISSUED BY THE CITY UW Job Address Z D� R*"� r�2�S., �� Permitee: 1 t t Telephone# ( cs) 333-5 370 Permittee Address: 7 '5 S fr\k.. L Gdz�Ek 2 a,AD! J (,4-&,,JvG(.�c f FL_ 221I I Requestipg Permission to Construct: A'9 T 'TD P(-4-4-E Zoe OF r'13212 V t A -Z-rnu La CIA n t h op. A,-t) 572 OG Pc,,--L k` 13 Q-2_. Do-' eg2,5-0 A cL LpC e- Jo3 }k-13e- toeLR.leN Location: (Reference to Cross-Street) AU-046i(-- Da-/py i1.AN"'-.i C e ._"> 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 (Y)' No ( ) Date: 3/L9/(7 Bell South Telephone Company t-3 bx Yes ( ) No ( ) Date: Ferrell Gas Yes (+f No ( ) Date: 3/2-1( 7 Comcast Yes (✓j No ( ) Date: Zt17 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 II 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 Trapsp rtation Standards and be performed under the supervision of l7 ika€U_A CO 'STA 4-' 74°•'-' GO C ntractor's Project Superintendent) located at Telephone#��o4)2-4,?'v36 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 7 Right of Way are to be included with this application. 7. This permittee shall commence actual construction in good faith with 3 0 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. c o,-7'tD.cTs J 0S.Q Go 144-e (30 C 333-S370 OWNER S2(261" 7 Atk(e+\Nct o4)4I ,-420 ' //3/rSigned: Date: Before me this day of ,1 in the o n State Of Florida,ha•:ersonal y appeared Notary Public at Large,State of Florida,County Duval. My commission expires: ersonally Known: _A-- • I' W*11111 , Produced Identificatidrr: ..tt JENNIFER JOHNSTON ••_SAte.,•j MY COMMISSION 8 GG 042ttIt4 :;; EXPIRES:October 27.2020 , i,,.�+? Bonded Tru Notary Public U d,wrlars i 7' e-. .. \t ,`1116330: , cl 1 r 10 j .. R t. ...kvo:1:. -A-62W:.' °:.7- 1 ''' MH-A-623A MH-A-623 } - �_ _ ® 6 ._ 444 -vior• i CD "418 4342. ' , 639A �. \ ' -.2.1._.'' Sao 836 • r98 . .: ta,*}� ... • \ ♦ "t +� .,�•� • �g,MFi�76:. w _ '!s tZ t •* ---il , 410‘. p. ..... 1, it4 • ' • ici-,-----iil i: ' \l, '' ' ' 111AV/ . „ = '' +- + r MH-A-642A 1� .r "f ': y, , e` MHA642 ' + t :? } r. : -(6 I i4.t ..." 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