390 PLAZA - DEMO ,,
r.�S y „j>rJ
. CITY OF ATLANTIC BEACH
"°- 1 `^> 800 SEMINOLE ROAD
1511::-:::,:y,`z ATLANTIC BEACH, FL 32233
-401119,- INSPECTION PHONE LINE 247-5814
DEMO - COMPLETE
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: DEMO17-0023
Description: DEMO HOUSE
Estimated Value: 10000
Issue Date: 11/30/2017
Expiration Date: 5/29/2018
PROPERTY ADDRESS:
Address: 390 PLAZA
RE Number: 169981 0000
PROPERTY OWNER:
Name: WEBER JULIEANN E
Address: 387 8TH ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: SHAPELL'S, INC.
Address: 8511 STOCKS RD Q/A: GUY LACHAPELLE
JACKSONVILLE, FL 32220
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 o At antic : eac
Permit Number: DEM017-0023 Description: DEMO HOUSE
Applied:11/16/2017 Approved:11/28/2017 Site Address:390 PLAZA _ ,
Issued:11/30/2017 Finaled: City,State Zip Code;Atlantic Beach,Fl 32233
Status: ISSUED Applicant:<NONE>
Parent Permit: Owner:WEBER JULIEANN E
Parent Project: Contractor:<NONE>
Details:
LIST OF CONDITIONS
SQ NO .'.ADDED,DATE. ' REQUIRED DATE ::;'SATISFY DATE TYPE STATUS
DEPARTMENT = CONTACT' ..' . :; REMARKS.
1 11/17/2017 EROSION CONTROL INSTALLATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Full erosion control measures`must be installed and'approved prior to beginning;anyeartl disturbing activities:=Contact the Inspection Line(247-
5814)to•request an Erosion and Sediment Control Inspection prior to start of construction •
2 11/17/2017 ON SITE RUNOFF INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes • `
All runoff must remain onsite during construction
3 11/17/2017 ROLL OFF CONTAINER INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes
Roll off container company must beon City approved list•(Advanced Disposal,Realco Recycling,Shapell's,Inc.;Republic{Services).. Container cannot
be placed on City`riight of way: -
4 11/17/2017 RIGHT OF WAY RESTORATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes
Full right'of-way restoration,including,sod,is'required- `
5 11/17/2017 RUNOFF INFORMATIONAL
•
PUBLIC WORKS Scott Williams
Note:" 'ef• 3 -
All runoff must remain onsite. Cannot raise lot elevation -
Printed:Thursday,30 November,2017 1 of 2 ��
f Permit Conditions
f.i
' City of Atlantic Beach --
6 11/17/2017 DOCUMENT IMPERVIOUS AREA INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes .
Strongly suggest thorough documentation,of impervious area's be recorded .. , -
7 11/17/2017 SLAB DRIVEWAY REMOVAL INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes.'
Slab and driveway tobe,fullyremoved.= .
•
8 11/17/2017 GRASS INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes , -. " -
Full site to be grassed _ ,'-%
9 11/27/2017 UNDERGROUND WATER SEWER INFORMATIONAL
UTILITIES
PUBLIC UTILITIES Kayle Moore
Notes.'' _ . .
Avoid`damage to underground water and;sewer utilities. Verify vertical and horizontal location of.utilities.-•Hand dig if necessary. If field
coordination is needed,call 247-58'84.-:_ • ° ,
10 11/27/2017 UTILITY MAP INFORMATIONAL
PUBLIC UTILITIES Kayle Moore
Notes
See attachedUtility Map.
11 11/27/2017 DISCONNECT AND CAP INFORMATIONAL
PUBLIC UTILITIES Kayle Moore
Notes.
Disconnect and cap water and sewer lines.L -
Printed:Thursday,30 November,2017 2 of 2 IP
St1.mh , City of Atlantic Beach APPLICATION NUMBER' - ,--
el
-c` 1 Building Department :(To be�assigned by the Building Department):
1, 800 Seminole Road -6yrlC t 7—0 23
ill.'- Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
ar E-mail: building-dept@coab.us Date routed:,- l t .,G7 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 390 p Liock, Department review required Yes -No
i _ire
Applicant: S t4 R-P CU S I p C -Planning &Zoning
Tree Administrator
Project: i t---- (\a 0 HO L) S E •ub' A ark
.blic Utilitie
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: proved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
PBUILDiN j
PLANNING &ZONING Reviewed by: 1 ---- Date: //a- P-7 7
TREE ADMIN. Second Review: ['Approved as revised. nDenied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. nDenied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
s1,.,u r City of Atlantic Beach APPLICATION NUMBER
41-1.t7,:':'..? -,. Building Department ( (To be assigned by the Building Department.)
t„ 00 1-.?;,, 800 Seminole Road
y T,i,44 1 Atlantic Beach, Florida 32233-5445 C) (7-0023
Phone(904)247-5826 • Fax(904)247-5845 NOV • r3 2017 1 l i t f t 7
afJ !
�'-13,'0. E-mail: building-dept@coab.us ; i1 ' )• Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 390 p LiAcick. Department review required Yes No
j Building
Applicant: S I (.4 P �� S l � C Planning &Zoning
Tree Administrator
Project: C=,1Vi �tO 0 .415-ii
:iPt-lblic-lJtilities+ .
Public Safety`—
Fire Services
rRevi:ew:fee'$ ._ 2._5-7 .. _ Dept Signature . __.1
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 L .
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: roved. ['Denied. ['Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: CV
P1/‘-- -Date: 11 2( l9
TREE ADMIN. Second Review: Approved as revised. ❑Denied. Not applicable
P ORKS Comments:
.40. ICiUTILITE51
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ElApproved as revised. ['Denied. ['Not applicable
Comments:
Reviewed by: Date:
Revised 05/1912017
r
?.Sr�`i;;1i�� City of Atlantic Beach APPLICATION NUMBER
Vii"1: -,''-�\st� Building Department :To be ea-signed by the Building Department.)
z .1 fJk ,y 800 Seminole Road
Atlantic Beach, Florida 32233-5445 17'1-17 .-.� ,_ . [I 0023
:
-: Phone(904)247-5826 • Fax(904)247-584.5 -- —
"!,,x;;19? E-mail: building-dept@coab.us I• j Date routed: ) I ( 7
City web-site: http://www.coab.us NOV 2017
ISI;
APPLICATION REVIEW-AND TRACKING FORM
Property Address: S90 pLA:k_ick. Department review required Yes No
C i m
Applicant: S t4 t -p eLLf J ( p Planning &Zoning
Tree Administrator
Project: ('--' NI, 0 NO u S E 'e'of-
_ blic Utilitie
Public Safety
Fire Services
eileWfoe $_"_. _ :. - Deptt Sigt ature:_v_ - _ - -
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
5 •
Florida Dept. of Environmental Protection �,
Florida Dept.of Transportation �/
St.Johns River Water Management District (c i�
Army Corps of Engineers "+
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
•
Other:
APPLICATION STATUS
Reviewing Department First Review: 71Approved. ['Denied. ['Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING /fr/7 /7
Reviewed b : Date:
TREE ADMIN. Second Review: ['Approved as revised. ['Denied. Not applicable
{fit7;BLG.C_V101,_ Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. ❑Not applicable
Comments:
Reviewed by: - Date:
Revised 05/19/2017
OFFICE COPY
.• Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 017- �O
3�0 CILa�A �TLA1J/IC_13EP�-w, FL— Permit Number, D G
Job Address: � /
Legal Description r--(.0� r -0/4e .ZMO ic-�ge°� a= 4V f/2-L (
l
Valuation of Work(Replacement Cost)$ I t /00°Heated/Cooled SF_ Non-Heated/Cooled_
• Class of Work(Circle one): New Addition Alteration Repair Move Dem. Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial esl en a
• If an existing structure,is a fire sprinkler system Installed?(Circle one): Yes ®° N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
P epnp OF Ek IS-no - HoP , RsVm.. c:, - p��S , 6-Rek.-D(IJ k7-4_l eda..l� r
Florida Product Approval# _for multiple products use product approval form
Property Owner Information 4 (g•riot ST _
Name: `1t"uE trN 0 e •WE L Address: 12
City An-atJrC- b 'r CU ^ _State f_ZIp_7-33 Phone 04' 3t2.4l42
E-Mail_ AtntA Eitcss N LA VS • Go N
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractorinformation .`p�J,�r,�, t.A�tt,kArp6ll.E
Name of Company: S I-4A PE US,, l*i L Qualifying Agent: Y
Address-%6 Srbu4s 1-0,6-0 _____CItyJ JirtU.Q State FL_Zip 72...1-2o
Office Phone 04••:486. 553 _lob Site/Contact Number
State Certification/Registration# E-Mall
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation ---
Exempt/insurer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg
construction in this jurisdiction.I understand that a separate permit.must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AiR CONDITIONERS,etc. .
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done to compliance with all
applicable laws regulating construction and zoning. -
WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.IF YOU INTEND
TO OBTAIN FINANCING,CONSULT WITH YOUR LENDR AN ATTORNEY BEFORE
RECORDING YO , NOTICE OF COMMENCEMENT. ! (,
—I
gnatura of Owner or Agent Including Contractor)
(Signature of Contractor)
. and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)before me 1?thisday of
1.1()J ,oZ011 by I CCY1YW\ANrOt(4111ker X017,by � C
qo(„a lc-N-0-1
of Notary
...ea.....s BRYNJ$*H 1 (Signature of Notary) (Signature' '.. .. .:_. ...
iy: y'c_ IIYCOIiI118810N#�I4ij <,,„y. `, LOIS K.NELSON
F�(PCRES%BgPiMMrIN fir } ..t MY COMMISSION#GG 033328
• g Personally Known OR :.; t,w• :*;
d I t "`cat O Produced Identification :i :** EXPIRES:October 30,2020 •
( Produced Iden ca •n' / ` ;into ' Bonded Thru Notary Public Underwriters
Type of Identification:��t V i S 1 (�'`n<� Type of Identification: _"L
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MAP SHOWING SURVEY OF
LOT 41, THE EAST 10 FEET OF LOT U, AND THE WE,aT ONE.•HALF OF LOT .39, BLOCK 10, ATLANTIC
BEACH, AS RECORDED IN PLAT BOOK 5, PAGE 69 OF THE CURRENT PUBLIC RECOHI)d OF DUVAL COUNTY,
FLORIDA.
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11/14/2017 Property Appraiser-Property Details
WEBER]IJLYTANN E : Primary Site Address Official Record Book/Page Tile#
387 8TH ST 390 PLAZA 17284-01861 9416
ATLANTIC BEACH, FL 32233 Atlantic Beach FL 32233
WEBER THOMAS A
390 PLAZA
Property Detail Value Summary
RE# 169981-0000 _ __ (_2017 Certified 2018 In Progress
Tax District I USD3 — — Value Method I CAMA CAMA
Property Use J 0100 Single Family Total Building Value $1,977.00 $1,977.00
#of Buildings i 1 _ Extra Feature Value $2.00 _ $2.00
For full legal description see Land Value(Market) $340,000.00 $340,000.00
i Legal Desc. Land&Legal section below Land Value LAgric.) $0.00 $0.00
i Subdivision 03101 ATLANTIC BEACH Just(Market)Value $341,979.00 $341,979.00
Total Area 11092 Assessed Value $341,979.00 $341,979.00
The sale of this property may result in higher property taxes.For more information go to Save — Cap Diff/Portability Amt $0.00/$0.00 $0.00/$0.00
—
Our Homes and our Property Tax Estimator.'In Progress'property values,exemptions and Exemptions $0.00 See below
other supporting information on this page are part of the working tax roll and are subject to
—
change.Certified values listed in the Value Summary are those certified in October,but may Taxable Value $341,979.00 See below
include any official changes made after certification Learn how the Property Appraiser's Office
values property.
Taxable Values and Exemptions—In Progress It J •
If there are no exemptions applicable to a taxing authority,the Taxable Value is the same as the Assessed Value listed above in the Value Summary box.
County/Municipal Taxable Value SJRWMD/FIND Taxable Value School Taxable Value
No applicable exemptions No applicable exemptions No applicable exemptions •
Sales History
Book/Page I Sale Date I Sale Price Deed Instrument Type Code (Qualified/Unqualified Vacant/Improved
17284-01861 18/14/2015 I$415,000.00 WD-Warranty Deed Qualified Improved
1 16271-01765 I 2/6/2013 I$100.00 SW-Special Warranty Unqualified • Improved
,01769-00339 11/1/1899 I$0.00 -Unknown Unqualified .Improved
•
.,•
Extra Features • J
LN I Feature Code I Feature Description 1 Bldg. I Length I Width I Total Units I Value
11 I FPPR7 I Fireplace Prefab 11 10 10 11.00 I$2.00
Land &Legal -J
Land _ Legal
LN I Code I Use Description I Zoning I Front I Depth I Category I Land Units I Land Type Land Value I I LN I Legal Description
1 �0100 I RES LD 3-7 UNITS PER AC I ARS-2 185.00 1130.00 I Common 11.00 I Lot I$340,000.00 I 1 5-69 16-2S-29E.250
2 ATLANTIC BEACH
3 LOT 41,E 10FT LOT 43,W1/2 LOT 39
4 BLK 10
Buildings
Building 1
. Building 1 Site Address ElementCode Detail
390 PLAZA Unit I .-.- - - I. I -...._
Atlantic Beach FL 32233 Exterior Wall 14 14 Wood Shingle \ ^I
Exterior Wall 6 6 Vertical Sheet cl—' I .
„t
n �z
Building Type 0103-SFR SPLIT-LEVEL Roof Struct 3 3 Gable or Hip H AOT I�j :,-r
Year Built 1954 Roofing Cover 3 3 Asph/Comp Shng �'—)L r
j Building Value 1 977.00 �, FUA L1
9 $ � Interior Wall 3 3 Plastered 1 � I_� j
Int Flooring 12 12 Hardwood BAS
,7 e I Gross Heated Effective I Int Flooring 7 7 Cork/Vnyl Tile L�-
—yp I Area Area Area
Heating Fuel 4 4 Electric
Addition 557 557 501 I Heating Type 4 4 Forced-Ducted J
Finished upper 558 558 530 • Air Cond 3 3 Central
story 1
Finished Open
Porch 166 0 50 I Element I Code I ._.
Finished Open 108 0 32 Stories 2.000
IPorch Bedrooms 4.000
Unfinished 52 0 21 Baths 1.500 I
'Storage •
Base Area 1204 1204 1204 Rooms/Units 1.000
Finished Open 65 0 20
'Porch
!Total 2710 2319 2358
http://apps.coj.net/pao_propertySearch/Basic/Detail.aspx?RE=1699810000 1/2
11/14/2017 Property Appraiser-Property Details
2017 Notice,of Proposed Property Taxes Notice(TRIM Notice)
TaxingDistrict
I Assessed Value I Exemptions I Taxable Value 7 Last Year I Proposed I Rolled-back
Gen Govt Beaches I$341,979.00 $0.00 I$341,979.00 $2,786.41 $2,787.54 $2,644.32
I Public Schools:By State Law 1$341,979.00 $0.00 $341,979.00 $1,556.74 $1,448.97 $1,476.84
_i By Local Board ($3_,979.09 $0 00 $341,979 60 I$768 46 $766_77 $779 III
FL Inland Navigation Dist. I$341,979.00 $0.00 $341,979.00 I$10.94 $10.94 $10.26
Atlantic Beach I$341,979.00 $0.00 $341,979.00 $1,103.63 $1,104.08 $1,049.26
Water Mgmt Dist.SJRWMD $341,979.00 $0.00 $341,979.00 $98.62 $93.16 $93.16
•Gen Gov Voted $341,979.00 $0.00 $341,979.00 $0.00 $0.00 $0.00
'School Board Voted $341,979.00 $0.00 $341,979.00 $0.00 $0.00 $0.00
Urban Service Dist3 $341,979.00 $0.00 $341,979.00 $0.00 $0.00 $0.00
Totals $6,324.80 $6,213.46 $6,002.87
_ Just Value Assessed Value Exemptions Taxable Value
Last Year $341,841.00 $341,841.00 $0.00 $341,841.00
i Current Year $341,979.00 $0.00 $341,979.00
I $341,979.00
2017 TRIM Property Record Card(PRC)
This PRC reflects property details and values at the time of the original mailing of the Notices of Proposed Property Taxes(TRIM Notices)in
August. •
Property Record Card (PRC)
The PRC accessed below reflects property details and values at the time of Tax Roll Certification in October of the year listed.
2017
2016
2015
2014
•To obtain a historic Property Record Card (PRC)from the Property Appraiser's Office,submit your request here: .!j_..1
More Information
:ontact Us I Parcel Tax Record I GIS Map I Map this property on Google Maps I City Fees Record
•
•
•
http://apps.coj.net/pao_propertySearch/Basic/Detail.aspx?RE=1699810000 2/2
.;;—; ;:; ,�
TREE E & VEGETATIONAFFIDAVIT '
7;;1= .. - a. Cllty of A1Oanttic Beach
h
__., Department of Community Development
- 2-' � Planning
ing&Coning Division
;, ;-_ << 800 Seminole Road Atlantic Beach,FL 32233
•
(P) 904 247-5800 (F) 904 247-5845 PERMIT# .
SECTII N I- ,'APPLLICANT INFORMATION f Owner(s) legal Authorized Agent*
NAME OF APPLICANT
..S 4-5-oy, .S�inirc/
NAME OF COMPANY S/,QJ J/ S j 'e)C
v
ADDRESS OF COMPANY �SC1 5/o4j Rat -3-c),d ?A ,?1210
PHONE 990tj-75 -J fQ3 CELL EMAIL 5 //s 0 Odis-044",, ._ ii/.4-
CONTRACTOR CERTIFICATION NUMBER
ATLBCH BUSINESS TAX RECEIPT NUMBER
SECTION II-SITE INFORMATI•N
STREET ADDRESS OF PROPERTY 3e/..0 fig IA ..5,- 44! F/ ,
?%i 4
If an address has not been assigned to this pro perty,contacttherAB'BuildingDepartmentat(904)247-5826 to request an address. i
LEGAL DESCRIPTION X- G.> H"-ZS' 2- C 25-& 144-4,1i.,— P `G
LOT el! BLOCK 6/k /k? SUBDIVISION
•
• REAL ESTATE NUMBER LOT OR PARCEL SIZE: SQ FT .2 1S AC '
RESIDENTIAL / COMMERCIAL OTHER(SPECIFY)
•
•
•
I affirm that 1 have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation"of the Municipal Code of
Ordinances for the City of Atlantic Beach,FL and/or I have participated in a pre-application meeting with the Administrator of those
regulations. Subsequently,1 affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed
from the above-described or ad' - t properties in conjunction with this project.
G�t/L i
NATURE OF OWNER •
NATURE OF OWNER 7
•
•
Signed and sworn before me on this/yday of f` , • ,�-� ,by State of ' ( •
'
County of 7)UV Q--,.( I
Identification verified: :S 3 — 24 7
illeitak •
Oath sworn: r Yes f No-.:r r-9); `=:;'.(14 ��'. /`= �'�'v"`� +"radr_.p
•
\ ;N , rl:•k1'. 2019TatarySignature r;' ., f� vC. " u
?tt= i;obar 6, t �•_= PJ Oh1PJIiSSION FF9
'i,:,'. ., - , 24951
• �.�~� ublicUnder�><�ter � -.�� EXPIRES:
October G,2D19 ,
.'!.y.,-,Ty _ Gcn�ed Thru P.o
- S y Commission expires: i�.!i‘...::::;(1-:;,:-.'-'-
. taryPubGcUndery 9L,
1..7 l: , ATLANTIC BEACH BUILDING DEPT.
�`. 4' • :4. DEMOLITION— PROPERTY OWNER
RELEASE FORM
Date: I t• 1W• k
To Whom It May Concern:
r
I/We the current property owners of: Lot 4\I EAST 1O "-P Lar` ' I 1/Z t4T 39
Block t d A-' NI•nc_ Ce IA-paseNtsl,aa t'Ar"
Legal Description of Property
AKA 3 9 0 Lis4%/ ` have contracted with to have
(Address of Property)
SiVer eu:s 1 g c • to remove the S 10(rteF1''. AL L'
(Company Nome) (Single Family.Duplex,Commercial.etc.)
Prier to the construction of: St 0'r- rA`"`t c'( •
-
As a condition of issuing the permit we agree to the following:
1. All utilities are to be located and clearly marked.
2. Once house is removed, lot is to be graded and leveled.
3. All construction debris is to be removed from the property.
4. Affected area is to have grass or seed in place. • .
5. Erosion control devices will be put in place and will remain in place until grass
has covered affected area or new structure is completed and landscaping is in
place. -
U L.I.e pt-NI J E, 1,AJ-t3-eYL
Signature
Signature
THIS SPACE FOR RECORDER'S USE ONLY
OWNER
Signed: Date: i 1 /i 1 1 I -
Berore me this 1 _day of Is MO "I in the Con of Duval,State
' �RAD
Of Florida,has personally appeared V<Y t '
Notary Public at Large,State v Floridan Coun of Duval.
.�, ;i'. IIY001<iiRSSpN#GG 1188yt My commission expires: C / � 1
�= B MWS:September 28,2021 Personally Known: or
' ,,,,arf Bonded'Mu Notary PUbland l an I Produced Identification: 1 i 7 a_