1637 Beach Ave driveway & landscape permit f �3
CITY OF ATLANTIC BEACH
} 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
%r0;3 v% 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: DWAY17-0029
Description: DRIVEWAY AND LANDSCAPE
Estimated Value: 30000
Issue Date: 3/16/2018
Expiration Date: 9/12/2018
PROPERTY ADDRESS:
Address: 1637 BEACH AVE
RE Number: 169652 0000
PROPERTY OWNER:
Name: ECKSTEIN JOSEPH P
Address: 1637 BEASCH AVE
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: STYLES CONSTRUCTION, INC.
Address: 1537 PENMAN RD SUITE A QA DARRELL GLEN SMITH
JACKSONVILLE BEACH, FL 32250
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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* 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.
_ Permit Conditions
City r Beach
•
Permit Number: DWAY17-0029 Description: DRIVEWAY AND LANDSCAPE
Applied: 12/20/2017 Approved: 3/8/2018 Site Address: 1637 BEACH AVE
Issued:3/16/2018 Finaled: City,State Zip Code:ATLANTIC BEACH, FL 32233
Status: ISSUED Applicant: <NONE>
Parent Permit: Owner: ECKSTEIN JOSEPH P
Parent Project: Contractor:<NONE>
Details:
LIST OF • •
SEQ NO ADDED DATE REQUIRED DATE SATISFY DATE TYPE STATUS
DEPARTMENT CONTACT REMARKS
1 12/28/2017 DRIVEWAY APRON INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
All concrete driveway aprons must be 5"thick,4000 psi,with fibermesh from edge of pavement to the property line. Reinforcing rods or mesh are
not allowed in the right-of-way. (Commercial driveways-6"thick).
2 12/28/2017 EROSION CONTROL INSTALLATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line(247-
5814)to request an Erosion and Sediment Control Inspection prior to start of construction.
3 12/28/2017 ON SITE RUNOFF INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
All runoff must remain on-site during construction.
4 12/28/2017 ROLL OFF CONTAINER INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapell's,Inc., Republic Services,Donovan
Dumpsters). Container cannot be placed on City right-of-way.
5 12/28/2017 RIGHT OF WAY RESTORATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Full right-of-way restoration,including sod,is required.
Printed: Friday, 16 March, 2018 1 of 2
3
r '.tdPermitConditions
City of Atlantic Beachj
i3�'rl
6 1/5/2018 UNDERGROUND WATER SEWER INFORMATIONAL
UTILITIES
PUBLIC WORKS 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 247-5834.
7 1/5/2018 METER BOX SEWER CLEAN OUT INFORMATIONAL
PUBLIC WORKS Kayle Moore
Notes:
Ensure all meter boxes,sewer cleanouts and valve covers are set to grade and visible.
8 1/5/2018 RT1 SEWER CLEANOUT INFORMATIONAL
PUBLIC WORKS Kayle Moore
Notes:
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.
000
Printed: Friday, 16 March, 2018 2 of 2
City of Atlantic Beach APPLICATION NUMBER
jS r s� Building Department (To be assigned by the Building Department.)
800 Seminole Road y��V q,
Atlantic Beach, Florida 32233-5445 U Act I — 0 0 Z /
Phone (904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: Z Z�
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 169 3-7 CAQ=B DgRgonient review required Yes No
S`' ld
Applicant: �_k:nnin
r Tree Administrator
Project: C—_" La Do zs Q Ap Gis Works
Pau lic 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:
EEDI N
PLANNING &ZONING Reviewed by: Date: ru/
TREE ADMIN. Second Review: ❑Approved as revised. ❑De ed. ❑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
r OFFICE CORY
r CITY OF ATLANTIC BEACH
' „ 800 Seminole Road
_, _ _ .� Atlantic Beach,Florida 32233
~�
REVISION REQUEST/ CORRECTIONS TO PLAN REVIEW COMMENTS
Date t Revision to Issued Permit Corrections to Comments_ Permit# DW�`�17-OOZ
Project Address
Contractor/Contact Name 0 5ellp �-�J.
Phone Email �J 0(f
Description of Proposed Revision/C ections: Permit Fee D $ s�•
el—N
Additional Increase in Building Value $ Additional S.F.
By signing below,I6ji C fV� affirm the Revision is inclusive of the proposed changes.
—�_
(printed name)
y _ f
Signa ac orgent(Contractor must sign if increase in valuation) Dat
(Office Use Only)
Approved_ Denied Not Applicable to Department
Revision/Plan Review Comments
Department Review Required:
( Building -, --JO41
�-"Planning &Zonin Reviewed By
Tree Administrator
Public Works 31 91201
Public Utilities
Public Safety Date
Fire Services
CITY OF ATLANTIC BEACH
MAR - 1 800 Seminole Road
2018 Atlantic Beach,Florida 32233
I°F I C E COPY
REVISION REQUEST /CORRECTIONS TO PLAN REVIEW COMMENTS
Date Revision to Issued Permit Corrections to Comments Permit#'NAJ
Project Address t�;??7�3MH AA� ,, ATLA(r[6 D 4
Contractor/Contact Name MR� �Mri H �C5��� Co I�j���aN
Phone( ) 7 Email J JMI't""z ; 0 M
Description of Proposed Revision/Corrections: Permit Fee Due $ 5'e'06
Additional Increase in Building Value $ Additional S.F.
By signing below,I LkCaffirm the Revision is inclusive of the proposed changes.
(printed name
L �... 1 f_
Signature of Contrac or/Agent(Contractor must sign if increase in valuation) Date
(Office Use Only)
Approved Denied Not Applicable to Department
Revision/Plan Review Comments
Department Review Required: ,,^
Buildin /711
and g Zoning Reviewed By
Tree dmirns
Public or s /
Public ti i ies
Pubic a e Date
Fire Services
City of Atlantic Beach APPLICATION NUMBER
_ Sst Building Department (To be assigned by the Building Department.)
800 Seminole Road 7
Atlantic Beach, Florida 32233-5445 Vy A� —L
Phone(904)247-5826 • Fax(904) 247-5845
E-mail: building-dept@coab.us Date routed: Z Z-C
City web-site: http://vmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: f � YZ I� �-� �I/r De ent review required Yes No
uildi
Applicant: S`T"�( Z CS (2("2),N2'S:Tnnin &Zonin
r Tree Administrator
Project: e Lr'}IIJO C— is Wor s
Pia lic Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
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
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
II (Circle one.) Comments:
PE Tc-ee
/
BUILDING J / /
PLANNING &ZONING Reviewed by: //L� Date:
TREE ADMIN. Second Review: XApproved as revised. ❑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
800 Seminole Road
Atlantic Beach,Florida 32233
REVISION REQUEST /CORRECTIONS TO PLAN REVIEW COMMENTS
Date 2 j `� g Revision to Issued Permit Corrections to Comments_ Permit# Q W Al 17 UOZ
Project Address
Contractor/Contact Named l '^
Phone TOY I�-i / �"` �' Email
Description of Proposed Revision/C ections: Permit Fee Due $
'Pee / v� , -( r O/3 e
Additional Increase in Building Value $ Additional S.F.
By signing below,I 4`1�7 affirm the Revision is inclusive of the proposed changes.
(printed name)
Signa c or gent(Contractor must sign if increase in valuation) Dat
(Office Use Only)
Approved z Denied Not Applicable to Department
Revision/Plan Review Comments
Department Review Required:
;0.44T't & Zoning Reviewed By
Tree minis rator
Public Works
Public Utilities 4
Public Safety Date
Fire Services
s l CITY OF ATLANTIC BEACH
I 800 Seminole Road
I'r MAR 1 2016 I�J Atlantic Beach, Florida 32233
REVISION REQUEST / CORRECTIONS TO PLAN REVIEW COMMENTS
Date XXRevision to Issued Permit Corrections to Comments Permit 9 D ^
Project Address L 6�77 �3M—CH
Contractor/ Contact Namey R,y�,,, 6M, i 1 H _JT_ r LZ6 CoN6A,W600ofq
Phone) �4 5' qt ()7 Email (� i, y ,� If Q
Description of Proposed Revision/Corrections: Permit Fee Due $
J;�r,,,5W 15LH (NAT10
1?AL Dd TM�r�� 45 nt�(!)A�ff) k WA)eS �N
Additional Increase in Building Value $ Additional S.F.
By signing below, 1 c xg4 L ," affirm the Revision is inclusive of the proposed changes.
f (printed nam
L j f �
Signature of Contras or/Agent(Contractor must sign if increase in valuation) Date
(Office Use Only)
Approved / Denied Not Applicable to Department
Revision/Plan Review Comments
Department Review Required:
Buildin 4%ems
annirrg & Zoning Reviewed By
"TreeAdminiss
Date
Fire Services
I
City of Atlantic Beach APPLICATION NUMBER
O� Building Department (To be assigned by the Building Department.)
800 Seminole Road �� 1
�. L v
Atlantic Beach, Florida 32233-5445 (��� 7 /
Phone (904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: Z Z Q It
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: f (J 3-7 �� C (?(-( VC_ DeValifflent review required Yes No
uildi
Applicant: S.)i t-- &S, �fj� `j - nninq &Zonin
r ) Tree Administrator
Project: Lip�QC— is works
Poi lic 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: W(Approved. ❑Denied. ❑Not applicable
(Circle one.) Comments:L r I
BUILDING � PIOIVIS t'U Jav�.4D
PLANNING &ZONING
Reviewed by' Date: g
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. [-]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
771
CITY OF ATLANTIC BEACH
r M 'i I 800 Seminole Road
s' MAR 0 2 2018 MA9 1 2013 1 Atlantic Beach,Florida 32233
REVISION REQUEST / CORRECTIONS TO PLAN REVIEW COMMENTS
Date Revision to Issued Permit � Corrections to Comments ' Permit#D wt,
Project Address 5E 6 H `J
Contractor/Contact Namey�k�
PhoneCJC7 �— - '0 Email �1
Description of Proposed Revision/Corrections: Permit Fee Due $
fth6li 5RO�Fr Ce)NIftZWal0� 154H ( 1 0
Additional Increase in Building Value $ Additional S.F.
By signing below,I -A ,,, '�„r�N affirm the Revision is inclusive of the proposed changes.
10V (panted name
L C , i
Signature of Contrar/Agent(Contractor must sign if increase in valuation) Date
(Office Use Only)
Approved Denied Not Applicable to Department
Revision/Plan Review Comments it �a"92 �asQnr-�(✓hQ,
Department Review Required:
Buildin
anning& Zo nni g Reviewed y
Tree Adminis
gi
*ae
PubliDate
Fire Services
jr�JjJJCity of Atlantic Beach APPLICATION NUMBER
Js r � Building Department (To be assigned by the Building Department.)
X 800 Seminole Road W RC1 1L _� 0�)Z 9
r) Atlantic Beach, Florida 32233-5445 _/ lJ
Phone (904)247-5826 • Fax(904)247-584 `- ZZO
'119? E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1693-7 (� 5AWA I/t� De ent review required Yes No
uildi
Applicant: � � �� Cc)L2�T - nnin & Zonin
r ] Tree Administrator
Project: (.._ADpaQAP C_ is works
Pva lic Utilities
Public Safety
Fire Services
Review fee Dept Signature 5—�' U,
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:
APPVCATION STATUS
Reviewing Department First Review: Approved. ❑Denied. []Not applicable
(Circle one.) Comments:
BUILDING IQhS �� IA + LVrC
i
PLANNING & ZONING [ Reviewed :bY
TREE ADMIN. Second Review: [-]Approved as revised. []Denied. ❑Not applicable
PU WORDS Comments:
BLIC UTILITIES
/ z- 2/-f7
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
CITY OF ATLANTIC BEACH
MA;4 - 7 ���$ 800 Seminole Road
AR 1 j Atlantic Beach, Florida 32233
MAR
r6, J --
REVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS
Date Revision to Issued Permit V/ Corrections to Comments' Permit#DM1}�y
Project Address y I fes► '-°� r_� ��f ;/
Contractor/Contact Name, oN
Phone � 'rj`T ' ' � Email l� � rJ i fi ti < �0
1
Description of Proposed Revision/Corrections: Permit Fee Due$
"ffn-oJ1 590MT Ce)NIft CY1O� HS I � �
LA% L-�N
Additional Increase in Building Value $ Additional S.F.
By signing below, I ,y kicA1N affirm the Revision is inclusive of the proposed changes.
(printed name
L �:.. 1 f
Signature of Contrao or/Agent(Contractor must sign if increase in valuation) Date
(Office Use Only)
Approved Denied Not Applicable to Department
PP PP P
Revision/Plan Review Comments r ah S -�o e,
Department Review Required: ,J
Building
anning& Zoning Reviewed By
Tree Adminis
Public Works 3
Public Uti i ies
Public a e o g Date
Fire Services
BUILDING PERMIT APPLICATION OFFICE COPY
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 ;�(�(�� _ �C)Z�
Job Address: /-63-7 F f�-A ii' 141L
Permit Number: l6-Ra,-u - 2961
Legal:Description -s�� f47rAY-ytjE5) ,5y_m=•3-V7-
�� Parcel #
Valuation of Work$ 3e,o o F oor Area o Sq. t. cl it
Proposed Work heated/cooled non-heated/cooled
Class o:F Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial elide ti
If an existing structure,is a fire sprinkler system installed?(Circle one): yes N/A
Florida Product Approval#
For multiple products use product approva orm —
Describe in detail the type of work to be performed: 17)Z-1-0L4a , ,/4tsse Lr�, 6L�t-PE �,a;er,�,,ti asp
�xS� f�/if-f��SGiH�t•-
Property Owner Information:
Name: 'ATOS ipN ,�Gt�f M --,j
Address: o . lr3 Z>" ,-o 77 P
_
City A-* )Je,14 Stated Zi 32"'A"
E-Mail er Fax#(Optional)_To£ �v qjz�;z-Lo,,� Phone 90+x+-
Contractor Information: CONTRACTOR EMAIL ADDRESS: /7� E�ti i s ,3So wrn_ t:
Compan-Name:_S�j-of Gd.xs�µ4 rral., , xr.4
,, Qty J4--
Qualifying Agent: 17A l�z�r c �/.x 7W
Address: (,f3-i � .aM�++ j � .sca�-rs. ,q Ciry Jay- �x State Zi 37-zs'o
Office Phone. efos� � .f"sir q10`�Job Site/Contact Number ?40&4- jr - 41 eti p
State Certilkation/Registration# G,3e... t Z r 6 d4,7 Fax#
ArcchitectName & Phone# (r:¢ 6- 'gGAoa Qoti
Engineer's Name& Phone# ,
Fee Simple Title Holder Name and Address�ofS.are EGKsrt,c„ o, d x �o�afl �-�- t3eA. 322-}to
Bonding Company Name and Address
Mortgage Lender Name and Address
flpplication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has conin:enced pries to the
issuance of a permit and that all work will be per formed to meet the standards of all laws regulating constr•zictiorn in this jurisdiction. This permit becomes null
and void if••wo•Ic isnot connzenced within six(6)months, or if constn•uction o•work is suspended or abandoned for apperiod of sia(6)months at any time after
work is commenced. I understand that separate permits must be secured o•Dectrica�l ff ork, Phznzbing,Signs, 6Vells, Pools, 6)naees, Boilers,Neatens,
Trucks and,4ir Conditiotters,etc.
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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUi NOTICE OF
COMMENCEMENT.
[here certify 11nat I/rave read and examined thds a plication and know the same to be true and correct. Ill provisions of laws and ordinances governing this
type oj3ivo•6:will be connplied nviih iwhether spec;red herein o•not. The granting of a permit does not presume to give authority to violate o-cancel the
provisions o;an},other federal,state, o•local law regulating construction or the pefomance of construction.
Signature of Owner
Signature of Contractojzc�.eel-?
Print Name Taxt'rtT 7-
.......................................................................... ._... Print Name ID"r r r- 'Iff
.... .....................
this 14 ......
efor We Before r e
Dav of acG ,-st a 20 �'�
this L'D y of D -20 n
Notary Public �;s ARLENSCOTTGAY Notary tblic =g.M�R«y pGGoso3s0
(; ;,Commission M GG 060380 rry: yy 28,2021
ON`;
Wuw y 28,2021
� SonOk ilru Troy F1ii Yrurmoe 10E3161019 �` `
OFFICE COPY
ORT File No.16071851
Agent File No.: 16B1945
Policy Number: OXFL-08493673
EXHIBIT A
ALL OF LOT 8 AND A PART OF LOT 9,NORTH ATLANTIC BEACH UNIT NO. 1,R-C-B-S CORPORATION,
AS RECORDED IN PLAT BOOK 15, PAGE 10 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY
FLORIDA,TOGETHER WITH A PORTION OF DEWEES AVENUE CLOSED BY DEED BOOK 1319, PAGE
427 OF SAID PUBLIC RECORDS,ALL BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS:
FOR A POINT OF BEGINNING COMMENCE AT THE SOUTHWEST CORNER OF SAID LOT 9,THENCE
NORTH 040 40'24" WEST ALONG THE EASTERLY RIGHT OF WAY LINE OF BEACH AVENUE,
(FORMERLY GARAGE APPROACH ROADWAY,A 30 FOOT RIGHT OF WAY AS NOW ESTABLISHED)A
DISTANCE OF 16.38 FEET;THENCE NORTH 81'5 1'35"EAST,A DISTANCE OF 202.91 FEET TO THE
EROSION CONTROL LINE FOR DUVAL COUNTY AS RECORDED IN PLAT BOOK 35 PAGES 59,59A
AND 59B OF SAID PUBLIC RECORDS;THENCE SOUTH 05053'06"EAST ALONG SAID EROSION
CONTROL,LINE,A DISTANCE OF 19.95 FEET;THENCE SOUTH 04114'24"EAST,CONTINUING ALONG +
SAID EROSION CONTROL LINE, A DISTANCE OF 51.39 FEET TO THE SOUTH LINE OF LOT 8;THENCE i
SOUTH 83018'16"WEST,ALONG SAID SOUTH LINE OF LOT 8,A DISTANCE OF 195.35 FEET TO SAID
EASTERLY RIGHT OF WAY LINE OF BEACH AVENUE,THENCE NORTH 13°05'55"WEST,ALONG SAID
EASTERLY RIGHT OF WAY LINE A DISTANCE OF 50.11 FEET TO THE POINT OF BEGINNING.
TOGETHER WITH THE LAND LYING BETWEEN THE EASTERLY BOUNDARY OF THE LANDS ABOVE
DESCRIBED AND THE ATLANTIC OCEAN.
t
t
ORT Form 4309 Page 3
ALTA Owner Policy of Title Insurance 6/06
Property Appraiser - Property Details Page 1 of 2
ECKSTEIN JOSEPH P 4. Primary Site Address Official Record Book/Page Tile#
1637 BEACH AVE 1637 BEACH AVE 17696-01313 9409
ATLANTIC BEACH, FL 32233 Atlantic Beach FL 32233
1637 BEACH AVE
Property Detail Value Summary
RE# 169652-0000 2017 Certified 2018 In Progress l
Tax District
US
Value Method CAMA CAMA
Property Use 0100 Single Family Total Building Value $113,238.00 $113,238.00
#of Buildings 2 Extra Feature Value 1$0.00 $0.00
Legal Desc. For full legal description see Land Value(Market) $1,482,400.00 $1,482,400.00
Land&Legal section below Land Value(Aeric.) $0.00 $0.00
Subdivision 03098 NORTH ATLANTIC BCH UNIT 1 Just(Market)Value $1,595,638.00 $1,595,638.00
Total Area 13859 Assessed Value $1,595,638.00 $1,595,638.00
The sale of this property may result in higher property taxes.For more information go Cap Diff/Portability Amt $0.00/$0.00 $0.00/$0.00
to Save Our Homes and our Property Tax Estimator.'In Progress'property values, Exemptions $0.00 See below
exemptions and 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 Taxable Value $1,595,638.00 See below
certified in October,but may include any official changes made after certification
Learn how the Property Appraiser's Office values property.
Taxable Values and Exemptions—In Progress
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 Sale Date Sale Price Deed Instrument Type Code Quallfied/Unqualified Vacant/Improved
17696-01313 8/29/2016 $2,138,700.00 MS-Miscellaneous Qualified Improved
17696-01315 8/19/2016 $100.00 WD-Warranty Deed Unqualified Improved
17274-02267 8/19/2015 $100.00 MS-Miscellaneous Unqualified Improved
05983-01815 7/10/1985 $100.00 WD-Warranty Deed Unqualified (Improved
00913-00388 1/1/1899 $0.00 -Unknown Unqualified Improved
Extra Features
No data found for this section
Land&Legal #j
Land Legal
LN Code Use Description Zonlna Front Depth Category Lam Land Value LN Legal Description
Units Trim _ 1 09-2S-29E.273
RES OCEAN LD 3-7 i Front
1 0140 UNITS PER AC ARS-2 68.00 1175.00 Common 68.00 Footage $1,482,400. 2 N ATLANTIC BEACH UNIT NO 1
Pr
3 LOT 8,9,PT CLOSED DEWEES AV
4 RECD 0/R 17696-1315
Buildings
Building 1
Building 1 Site Address Element Code Detail F-
1637 BEACH AVE Unit --
Atlantic Beach FL 32233 Exterior Wall 14 14 Wood Shingle
_ Roof Struct 3 3 Gable or Hip _rPAL
—�
Building Type 0108-SFR CLASS 2 Roofing Cover 13 3 Asph/Comp Shng L
Year Built _' 1936 Interior Wall5 5 Drywall L-1 eas:ruA
Building Value $94,099.00 j Interior Wall 6 6 Wood Custom L-1 ri
�
Int Flooring it 11 Cer Clay Tile —T
LBAS�F
TvDe Gross Fleeted Effective Int Flooring 12 12 Hardwood s I
Area Area Arca J
Heating Fuel 4 4 Electric
Fin Screened 600 0 210 Heating Type 4 4 Forced-Ducted
Porch
Balcony bop 0 gp Air Cond 3 3 Central
Balcony 15 0 2
http://apps.coj.net/PAO—PropertySearch/Basic/Detail.aspx?RE=1696520000 12/27/2017
Property Appraiser- Property Details Page 2 of 2
Base Area 1165 165 (165 I I Element I Code
Balcony 165 j 0 25 Stories 12.000
Base Area 1252 1252 1252 (Bedrooms 4.000
Finished upper 1252 1252 1189 Baths 2.500
51ory 1 (Rooms/Units 1.000
Base Area 192 192 192
Finished 1140 0 70
Storage
Total
14381 2861 13195
2017 Notlice of Proposed ProR2rty Taxes Notice M Notice)
Taxing District i Assessed Value Exemptions Taxable Value Last Year Proposed Rolled-back
Gen Govt Beaches ($1,595,638.00 $0.00 {$1,595,638.00 $15,817.77 $13,006.36 $12,338.11
Public Schools:By State Law $1,595,638.00 I$0.00 ($1,595,638.00 $8,837.24 $6,760.72 $6,890.76
By Local Board I$1,595,638.00 $0.00 $1,595,638.00 $4,362.35 $3,586.99 I$3,401.58
FL Inland Navigation Dist. ($1,595,638.00 $0.00 $1,595,638.00 $62.10 $51.06 I$47.87
Atlantic Beach I$1,595,638.00 I$0.00 I$1,595,638.00 $6,265.05 $5,151.52 $4,895.74
Water Mgmt Dist.SJRWMD $1,595,638.00 $0.00 $1,595,638.00 $559.85 $434.65 $434.65
Gen Gov Voted I$1,595,638.00 $0.00 $1,595,638.00 $0.00 $0.00 $0.00
School Board Voted I$1,595,638.00 $0.00 $1,595,638.00 $0.00 $0.00 $0.00
Urban Service Dista I$1,595,638.00 I$0.00 $1,595,638.00 $0.00 $0.00 !$0.00
Totals $35,904.36 $28,991.30 $28,008.71
Just Value Assessed Value Exemptions Taxable Value
Last Year $1,940,545.00 $1,940,545.00 $0.00 $1,940,545.00
Current Year $1,595,638.00 $1,595,638.00 $0.00 $1,595,638.00
2017 TRIM Property Record Card(PRQ
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
t
•To obtain a historic Property Record Card(PRC)from the Property Appraiser's Office,submit your request here:
More Information
ontact U I Parcel Tax Record I GISM Map this property on Google Mai)s I City Fees Record
http://apps.coj.net/PAO_PropertySearch/Basic/Detail.aspx?RE=1696520000 12/27/2017
FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION
r Division of Water Resource Management
t Coastal Construction Control Line Program
t 2600 Blair Stone Road,M.S.3522
FL A Tallahassee,FL 32399-2400
Phone:(850)245-7669 8032855 DU
Permit Number
No.of Pages Attached:
FIELD PERMIT PURSUANT TO SECTION 161.053 OR 161.052,FLORIDA STATUTES
FINDINGS OF FACT AND CONCLUSION OF LAW:The request for a field permit was considered by the staff designee of the Department of Environmental
Protection and found to be in compliance with the requirements of Chapter 6213-33,Florida Administrative Code(F.A.C.).Approval is specifically limited to the activity
in the stated location and by the project description,approved plans(if any),attached standard conditions,and any special conditions stated below pursuant to Paragraph
161.053(5),Florida Statutes(F.S.).This permit may be suspended or revoked in accordance with Section 62-4.100,F.A.C.
PROJECT LOCATION:
1637 Beach Ave., Atlantic Beach; Duval County. 75'to 150' south of R-46
PROJECT DESCRIPTION:
1. Installation of sand set TX T paver block walkway located north side of dwelling.
***Seaward landscaping within the developed lot landward of existing bulkhead to include;A)+/-
200cy of FDEP approved sand fill.
B)Planting of 6 Royal palm trees(3 Per property line)
C)Placement of approved decorative gravel and upland supplied coquina boulders for creation of seating area.
D)Landscape plantings of non-invasive vegetation.
SPECIAL PERMIT CONDITIONS:The permit is valid only after all applicable federal,state,and local permits are obtained and does not authorize contravention
of local setback requirements or zoning or building codes.This permit and public notice shall be posted on the site immediately upon issuance and shall remain posted
along with local approval until the completion of any activity authorized by this permit.Other special conditions of this permit include:
1. All work shall remain within the existing developed lot landward of bulkhead.
2. Lighting is not authorized by this permit.
3. All work shall meet all local codes.
STANDARD PERMIT CONDITIONS:The permittee shall comply with the attached standard field permit conditions.
APPLICANT INFORMATION:I hereby certify that I am either:(I a)the owner of the subject property or(Ib)I have the owner's consent to secure this permit on the owner's
behalf,and that(2)I shall obtain any applicable licenses or permits which may be required by federal,state,county,or municipal law prior to commencement of the authorized
work;(3)I acknowledge that the authorized work is what I requested;and(4)I accept responsibility for compliance with all permit conditions.
Applicant's Signature KP Date 02-13-2018 Telephone No. 9( 04)669-9357
Applicant's Printed Name KEVIN PARTEL Address 4230 Myrtle Street Saint Augustine, FL 32084
If applicant is an agent:
Joseph P Eckstein 1637 Beach Ave Atlantic Beach, FL 32233 (904)829-0851
Printed name ofproperty owner Property owner's address Property owner's telephone no.
DEPARTMENT FINAL ACTION AND FILING AND ACKNOWLEDGMENT:This field permit is approved on behalf of the Department of Environmental Protection
by the undersigned staff designee,and filed on this date,pursuant to section 120.52,F.S.,with the undersigned designated Deputy Clerk,receipt of which is hereby
acknowledged.
1e�� Trey J. Hatch 02/13/2018
�L i i stag
DFs gne puty Cipir Printedame or DesigneelDeputy Clerk Date
08/13/2018
EXPIRATION DATE:
(Emergency permits issued pursuant to Section 6213-33.014,F.A.C.,are valid for no more than ninety days and other field permits are valid for no more than 12
months.The staff designee may specify a shorter time limit.)
EMERGENCY PERMIT: YES NO Approved plans are attached: YES NO
POST PERMIT AND PUBLIC NOTICE CONSPICUOUSLY ON THE SITE
r
t
PUBLIC NOTICE
The foregoing constitutes final agency action.Any person whose substantial interests are affected by any decision made by the
Department on the Field Permit has a right to request an administrative hearing in accordance with the provisions of Sections 120.569 and
120.57,F.S.The request for an administrative hearing must comply with the provisions of Rule 28-106.201,F.A.C.,and must be received
by the Department(at the address given below)within twenty-one(2 1)days from the date of this notice.
When the Department receives an adequate and timely filed request for hearing,the Department will request the assignment of an
administrative law judge.Once the administrative law judge is requested,the Division of Administrative Hearings will have jurisdiction
over the formal proceeding and the Department(as the referring agency)will take no further action with respect to the proceeding
except as a party litigant.
Section 120.54(5)(b)4,F.S.,and Rule 28-106.201(2),F.A.C.,explain that the following items must be included in a petition for a formal
administrative hearing
(a) The name and address of each agency affected and each agency's file or identification number, if known;
(b) The name, address, any e-mail address, any facsimile number,and telephone number of the petitioner, if the petitioner is not
represented by an attorney or a qualified representative; the name, address, and telephone number of the petitioner's
representative,if any,which shall be the address for service purposes during the course of the proceedings;and an explanation
of how the petitioner's substantial interests will be affected by the agency determination;
(c) A statement of when and how the petitioner received notice of the agency decision;
(d) A statement of all issues of material fact disputed by the petitioner,or a statement that there are no disputed facts;
(e) A concise statement of the ultimate facts alleged,including a statement of the specific facts that the petitioner contends
warrant reversal or modification of the Department's action;
(f) A statement of the specific rules or statutes the petitioner contends require reversal or modification of the Department's
action,including an explanation of how the alleged facts relate to the specific rules or statutes;and
(g) A statement of the relief sought by the petitioner,stating precisely the action that the petitioner wants the Department to take
with respect to its action.
A person may request an extension of time to petition for an administrative hearing.The person filing the request for extension must do so within
the time limits for filing a petition described above. The request must state why an extension of time is needed. The Department will grant an
extension only when good cause is shown.
If a petition or a request for time extension is filed,further order of the Department becomes necessary to effectuate this Field Permit.Accordingly,
the Department's final action may be different from the position taken in this notice.Actions undertaken by any person under this permit,pending
the lapse of time allowed for the filing of such a request for hearing,may be subject to modification,removal,or restoration.
Failure to petition within the allowed time frame constitutes waiver of any right that a person has to request a hearing under Section 120.57,F.S.,
and to participate as a party to the proceeding.If a legally sufficient petition for hearing is not timely received,this notice constitutes final agency
action.
When this order becomes final and is filed with the Department Clerk,any party to the order has the right to seek judicial review under Section
120.57, F.S., and Rule 9.030(b)I(c)and 9.110, Florida Rules of Appellate Procedure. A notice of appeal must be filed within thirty (30) days
with both the Department Clerk(see address below)and with the appropriate district court of appeal.The notice filed with the district court must
be accompanied by the filing fee specified in Section 35.33(3), F.S. Any subsequent intervention will be only by the approval of the presiding
officer on motion filed under Rules 28-5.207 or 60Q-2.010,F.A.C.
All requests for hearings are to be filed with the Department at the following address:
Florida Department of Environmental Protection
Office of General Counsel
Department Clerk
3900 Commonwealth Boulevard
Mail Station 35
Tallahassee,Florida 32399-3000
8032855 DU
Permit Number:
STANDARD FIELD PERMIT CONDITIONS
Tlit'following conditions shall apply to FIELD PERMITS(unless waived by DEP or modified by special permit condition). In the event of a
conflict between a field permit condition and a special permit condition,the special condition shall prevail.
1) The permittee shall carry out the construction or activity for which the permit was granted in accordance with the plans and
specifications that were approved by DEP as part of the permit.Any deviation there from shall be grounds for suspension of the work
and revocation of the permit pursuant to Section 120.60(7),F.S.,and may result in assessment of civil fees or issuance of an order to
alter or remove the unauthorized structure,or both.No other construction or activities shall be conducted.No modifications to project
size,location,or structural design are authorized.A copy of the permit shall be conspicuously displayed at the project site.
2) The permittee shall conduct the construction or activity authorized under the permit using extreme care to prevent any adverse impacts
to the beach and dune system,marine turtles and their nests and habitats,or adjacent property and structures.
3) The permittee shall allow any duly authorized member of the staff to enter upon the premises associated with the project authorized by
the permit for the purpose of ascertaining compliance with the terms of the permit and with the rules of DEP,until all construction or
activities authorized or required in the permit have been completed and the project accepted by DEP.
4) The permittee shall hold and save the State of Florida,DEP,its officers and employees,harmless from any damage(no matter how
occasioned and no matter what the amount)to persons or property that might result from the construction or activity authorized under
the permit and from any and all claims and judgments resulting from such damage.
5) The permittee shall allow DEP to use all submitted records,notes,monitoring data,and other information relating to construction or
any activity under the permit for any purpose it may deem necessary or convenient,except where such use is otherwise specifically
forbidden by law.
6) Construction traffic shall not operate and building materials shall not be stored on vegetated areas seaward of the control line,unless
specifically authorized by the permit. If(in the opinion of DEP staff this requirement is not being met,positive control measures
shall be provided by the permittee at the direction of DEP staff. Such measures may include temporary fencing,designated access
roads,adjustment of construction sequence,or other requirements.
7) The permittee shall not disturb existing beach and dune topography and vegetation except as expressly authorized in the permit.
Before the project is considered complete,any disturbed topography or vegetation shall be restored(as prescribed in the permit)
with suitable fill material or revegetated with appropriate beach and dune vegetation.
8) The fill material shall be obtained from a source landward of the control line and shall consist of sand which is similar to that already
on the site in both grain size and coloration.This fill material shall be free of construction debris,rocks,or other foreign matter.A
sample of the sand shall be provided to the staff representative of the Bureau of Beaches and Coastal Systems during the
preconstruction conference.
9) If surplus sand fill results from any approved excavation seaward of the CCCL,such material shall be distributed seaward of the
CCCL on the site,as directed by DEP staff(unless otherwise specifically authorized by the permit).
10) Any native salt-resistant vegetation destroyed during construction shall be replaced with plants of the same species or,by
authorization of DEP,with other native salt-resistant vegetation suitable for beach and dune stabilization.Unless otherwise
specifically authorized by the staff,all plants installed in beach and coastal areas(whether to replace vegetation displaced,
damaged,or destroyed during construction or otherwise)shall be of species indigenous to Florida beaches and dunes(i.e.,sea oats,
sea grape,saw palmetto,panic grass,salt meadow hay cord grass,seashore salt grass,and railroad vine).
11) All topographic restoration and revegetation work is subject to approval and acceptance by DEP staff.
12) If not specifically authorized elsewhere in this permit,no operation,transportation,or storage of equipment or materials is authorized
seaward of the dune crest or rigid coastal structure during the marine turtle-nesting season.The marine turtle-nesting season is May 1
through October 31 in all counties(except Brevard,Indian River,St.Lucie,Martin,Palm Beach and Broward counties where marine
turtle nesting occurs during the period of March 1 through October 31).
13) If not specifically authorized elsewhere in this permit,no temporary lighting of the construction area is authorized at any time during
the marine turtle-nesting season and no additional permanent exterior lighting is authorized.
14) This permit has been issued to a specified property owner and is not valid for any other person.
8032855 DU
Permit Number:
DEP form 73-122(Updated 5/05)
TREE & VEGETATION AFFIDAVIT
City of Atlantic Beach
a Department of Community Development
v Planning&Zoning Division P(a/.A Y I - O zq
800 Seminole Road Atlantic Beach,FL 32233
(P)904 247-5800 (F)904 247-5845 PERMIT# -
SECTION I-APPLICANT INFORMATION PK Owner(s) i Legal Authorized Agent*
NAME OF APPLICANT 'To,S1,ni /� scdrjcsr4
NAME OF COMPANY
ADDRESS OF COMPANY 7.o- j30 s- S'O nfr Tore.t<fOr �yA-+-t. Bo N. j;�C, 3z.s�v
PHONE 40J1-1Ag, lova CELL 9oLj,gS-r- 1&4&41 EMAILyoL� TLTJr;c-f e
CONTRACTOR CERTIFICATION NUMBER
ATLBCH BUSINESS TAX RECEIPT NUMBER
C 1 2017
SECTION II -SITE INFORMATION
STREET ADDRESS OF PROPERTY f J 37
Ifan address has not been assigned to this property,contact the AB Building Department at(904)247-5826 to request an address.
LEGAL DESCRIPTION A7ri+r,M.o J'*-y W-J3VT- M
LOT BLOCK SUBDIVISION
REAL ESTATE NUMBER /6 9 Yi - dma0 LOT OR PARCEL SIZE: 1 3,d V6 SQ FT AC
RESIDENTIAL L/ COMMERCIAL OTHER(SPECIFY)
1 affirm that I 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 1 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 adjacent properties in conjunction with this project.
SIGNATURE OF SIGNATURE OF OWNER
Signed and sworn before me on this day ofc'"�{Q 2etti ,by State of
�OLt,JK ? EG r<S>i t.v County of DOW-"'
Identification verified:
Oath sworn: (:/Yes i No
Notary Signature
My Commission expires: ARLENSCOTT GAY
C=n6sw N GG 080380
Van
am"TMT YOMO 000.3057019
RIGHT-OF-WAY/EASEMENT PERMIT
:'�✓Y Permit#Issued by the City of Atlantic Beach
PERMITTEE RESPONSIBLE FOR NOTIFYING;811 AND OBTAINING UTILITY LOCATES
Job Address V90(' aW. Q,v C Phi ne �� j� --
Permittee //SQr✓�J — G S„yly` Email/D2 /'7� .
Requesting Permission to Construct
Location(Reference to Cross-Street)
• Pennittee declares that prior to filing this application they have ascertained the location of all existing utilities,
both aerial and underground and the accurate locations are shown on the sketches.
• 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 said poles,wires,pipes,cables or other facilities and appurtenances authorized hereunder,shall
be ilmmediately 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.
• All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed
under the supervisionof ���e l� / 1 (Project Superintendent)
with Company Name e.$ Phone 9W,11' —
• All materials and equipment shall be subject to inspection by the Director of Public Works.
• All city property shall be restored to its original condition as far as practical,in keeping with City specifications
and the mamner satisfactory to the City.
• 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. CalctdatiOns showing any increase in impervious area on owner's lot or in the City
right-of-way are to be included with this application.
• The permittee shall commence actual construction in good faith withilizia 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.
• 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.
• The Director of Public Works shall be notified twenty-four(24)hours prior to starting work and again
immediately upon completion.
P gne in r Date f
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this day of �C'cJ'►+� ,20 11
(printed name of Pe )
who personally appeared before me and
acknowledged that he/she signed th sttument voluntarily for the purpose expressed in it.
Personally Known
Signaturo of Notary Public,St e of Fle ida Produced Identification(Type)
�f+ �ARLENSCOTTGAY
r g,tCarrtdssbn k GO 080380
,�EaDir�s January 28,2021
ft T"F*Wwuo 14191s1D1�
a ry REVOCABLE ENCROACHMENT PERMIT
REVOCABLE ENCROACHMENT PERMIT by the City of Atlantic Beach,Florida,a municipal corporation
organized and xistingun the laws of the SSttateofFlorida,hereinafter referred to as"CITY"and
--- ..V &F A dl
referred to as"USER . of Atlantic Beach,Florida,hereinafter
WITNESSETH:
That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the
property for the purpose as described in the City of Atlantic Beach.
This work is generally described as
Any facility maintained, repaired, erected, and/or instated in the exercise of the privilege granted remains subject to
relocation or removal on thirty(30)days'notice by CITY to USER,said notice to USE hall be given by certiMeof return receipt requested,to the following address Q Q Q � � ������
• In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter�2���
i
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 ofthe 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"
• 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 within 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 right-of-ways 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
Date 1 Lf
Property U Wner/Ageffit ksignedin presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this /�I�" day of D�4,6- +j34.rZ .20 t'7
by F.
,who personally appeared before me and
(printed name of Signer)
acknowledged that he/she signed the i ument voluntarily for the purpose expressed in it.
Signature of Notary Public,State of Florida
Personally Known
Approved/Public Works Department:
Produced Identification(Type)
ARLENS CATTGAY Scott Williams,Public orks Director
<<1Curomisfon#GG 0603&9
Ar Elites January 26,2021
Boo4W1ThruTmyF*k urnmJXn5-1019