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1912 SEA OATS DR - DRIVEWAY PERMIT �� ':Aifi''` �6 CITY OF ATLANTIC BEACH r V` '� > 800 SEMINOLE ROAD 7.51,_ "r ATLANTIC BEACH, FL 32233 `40;s 9� INSPECTION PHONE LINE 247-5814 DRIVEWAY - SINGLE OR TWO FAMILY DRIVEWAY MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: DWAY17-0010 Description: REPLACE CONCRETE DRIVEWAY WITH NEW CONCRETE Estimated Value: 0 Issue Date: 8/23/2017 Expiration Date: 2/19/2018 PROPERTY ADDRESS: Address: 1912 SEA OATS DR RE Number: 172020 0910 PROPERTY OWNER: Name: MARKULIK JEFFREY F Address: 1912 SEA OATS DR ATLANTIC BEACH, FL 32233-4514 GENERAL CONTRACTOR INFORMATION: 0 Name: Address: Phone: Name: A-ONE CONCRETE SERVICES INC Address: , Phone: PERMIT INFORMATION: Please see attached conditions of approval. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. * A notice of Commencement is only required for work exceeding an estimated value of $2,500. For HVAC work, a Notice of Commencement is only required when HVAC work exceeds and estimated value of$7,500. City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road W R\/ ( 7- 00 1 a \v �� Atlantic Beach, Florida 32233-5445 /! Phone (904) 247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: i, Z S' ic (QTS birepartment review required Yes No Applicant: I `"C)1 3 Cot1/4__DC(2TC. (-15-tannin &Zonin Tree ministrator Project: 0--01 .D (.,STC—_ cD12--�'\i :Lfl rPublic Works Public Utilities 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: Approved. Denied. Not applicable (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by:/ �t� Date: 17 TREE ADMIN. Second Review: ['Approved as revised. ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ❑Denied. INot applicable Comments: Reviewed by: Date: Revised 05/19/2017 JCity of Atlantic Beach APPLICATION NUMBER (----.0-tvi-,../, `\ Building Department ' zl,.:E Rw'�a.-', (To be assigned by the Building Department.) <., • 800 Seminole Road R �, �� Atlantic Beach, Florida 32233-5445 �� / 7- 00 Phone(904)247-5826 • Fax(904)247 45AUG 0 3 2017 �r,;1 !) E-mail: building-dept@coab.us Date routed: a t City web-site: http://www.coab.us By: APPLICATION REVIEW AND TRACKING FORM Property Address: 6 `1 SCA 0,„ R. epartment review required Yes No id. _ Applicant: IA — ND& C_O�C _TC= planning &Zonin , Tree Administrator Project: Q aRE---(= Df2A v-(,E / `public Works—� Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review Receipt Date of Permit or 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. ['Not applicable (Circle one.) Comments: Jei ,fehG4 SLG► BUILDING PLANNING & ZONING Reviewed bk..41.0_4004,. Date: ��-// TREE ADMIN. Second Review: A roved as revised. ❑ pp ['Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. ['Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 ' * CITY OF ATLANTIC BEACH CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS ' � 800 Seminole Road 904-247-5800 .t Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 J CAI , t x'hotrn'O p Lo ye'hoo PERMIT# DW4L/17-0O,C'� PLEASE SUBMIT(2)COMPLETE SETS OF PLANS WITH APPLICATION. Date 7/4 / 7 ISSUES BY THE CITY Job Address p lam' (, E-mail trn1i'nL 1 (9 P /C,Joo -4Dm Permitee: ONl C, Telephone#qoq" 5) `1' 3777 Permitee Address: J O OW 1 1(- Ca,�(�., �G�-fl -C 3 ( 3 , � �vl Requesting Permission to Construct: Location: (Reference to Cross-Street) 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 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 (Contractor's 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 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, 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 Si -ne� t !/ •t-6(,.( Date I / � r efore me this �� day 9 of 14'1 in the •unty,of uval, State Of Florida, has personally appeared jc(.(- -y - S . ?e; GRACE NI/Asir- );Int, / NotaryPublic at Large, State of Florida. County of Duval. My ••' ah MYCOMMISSI a 3-(--)).<.: ovally Known: r `:o EXPIRES:October 27,2020 roduced IdentlflcatiOr ( rte St-t Ciar S:1? ':Fo7C:0".•' Bonded Tru Notary PubL U,dm rotas /29/15 R.O.W.Permit Attachment of for R.O.W.Permit# issued , 20 Atlantic Beach,FL 32233 Owner's Name: jI $ Q\00/1C Lai Property Address: n ' Ocd Cl{ -tAt e 6Ch ( FL 3 33 Subdivision: R.E. #: REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of , 20 )7, by Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of the State of Florida,hereinafter referred to 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: (Q"movai 1/e_,A H- D . 0 "g- Con emQ.. ci.(cre...(A.)eT 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 •e giv- b, - 'feed mail, etum receipt r-• ested, to •- followin_ 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 inure 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 terns of this permit and that all of said liabilities are hereby assumed by the USER. DATED and SIGNED this pi day of Wt 20 17 l • • i.. 4 • ". .it I er (to be signed in prese ce of the Notary) STATE OF FLORIDA COUNTY OF DUVAL On this 2 F day of -5ua , 20 17 , personally appeared before me, a Notary Public in and for said Cot#nty and State, 5p4 j Mc rk i k, the property owner of (q12 fl�,�- , Atlantic Beach, Florida, known to me to be the person(s) described in and who executed the foregoing instrument; who acknowledged to me that he or she execu ed the same freely and voluntarily and for the uses and purposes therein mentioned. 1�1u N r ry Public in for pfd County and State 'xt:"'• GRACE MACKEY L, MY COMMISSION#GG 042989 * °u4a1EXPIRES:October 27,2020 ;,fir °PP Bonded Thru Notary Public Underwriters CITY OF ATLANTIC BEACH,FLORIDA, a municipal corporation: Approved: Scott Williams Interim Public Works Director File: 12/12/16 Page 2 of 2 I' 1