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664 Beach Ave DWAY18-0026 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 DRIVEWAY- SINGLE OR TWO FAMILY DRIVEWAY MUST CALL BY 4PM FOR NEICT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: DWAY1&-0026 Description: Replacing Concrete Driveway with Pavers Estimated Value: 12200 Issue Date: 8/16/2018 Expiration Date; 2/12/2019 PROPERTY ADDRESS: Address: 664 BEACH AVE RE Number: 1701280000 PROPERTYOWNER: Name: MELANCON DEJEAN JR Address: 664 BEACH AVE ATLANTIC BEACH, FL 32233 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: Comprehensive Home Services, LLC Address: 4980 Devils Den Road Keystone Heights, FL 32656 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 requirernents of this permit, dim 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 12 City of Atlantic Beach Permit Number: DWAY18-0026 Description:Replacing Concrete Driveway with Pavers Applied:8/14/2028 Approved:8/15/2018 Site Address:664 BEACH AVE Issued:8/16/2018 Finaled: City,State Zip Code:Atlantic Beach,FI 32233 Status:ISSUED Applicant:<NONE> Parent Permit: Owner:MELANCON DEJEAN III Parent Project: Contractor:<111I Details: LIST OF CONDITIONS SEQNOJ ADDEDDATE REQUIREDDATE1 SATISFYDATE TYPE STATUS DEPARTMENT CONTACT REMARKS 1 1 8/15/2018 EROSION CONTROL INSTALLATION INFORMAL IONAL PUBLIC WORKS Scott Williams Notes: Full enosion contral measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line 1247- 5814)to request an Erosion and Sediment Control Inspection prior to start of construction. 2 1 9/15/2018 1 7___0N SITE RUNOFF INFORMATIONAL PUBLICWORKS Scott Williams Notes: All runoff must remain on-site during construction, 3 1 8/15/2018 1 ROLL OFF CONTAINER INFORMATIONAL PUBLIC WORKS Scott Williams Notes: Roll off container Company must be on City approved list JAdvanced Disposal,Realm Recycling,Shapell"s,Inc.,Republic Services,Donovan Dumpsters). Container cannot be placed on City right-of-my. 4 8/15/2018 _FR GOT OF WAY RESTORATION INFORMATIONAL PUBLIC WORKS Sc.tt Williams Notes: Full right-of-way restoration,including sod,is required. 5 1 8/1 _2018 1 1 RUNOFF INFORMATIONAL PUBLICWORKS Scott William, Notes: All runoff must remain on-site. Cannot raise lot elevation. 101, Printed:Thursday,16 August,2018 1 of 2 1- City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach,Florida 32233-5446 Phone(904)247-5826- Fax(904)247-5845 E-mail: building-dept@coalb.us Date muted: Ilk City web-site: http:/Avww.coab.us I - — APPLICATION REVIEW AND TRACKING FORM Property Address: (eb� pwe' Department review required Yes No Build ng SVC Applicant: C0fXDr_1eh9MS1ye� J('Plannino&ZonlZ Project: gemb�& 1,<TJj2Ce !�J Tree Administrator Public Utilities PA-W3 Public Safety Fire Services Review fee $ Rev'ew Other Agency Review or Pemnit Required Of Pemu,=%, Date Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Any Corps at Engineers Division of Hotels and Restaurants DiAsion of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: pproved. ODenied. []Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by:.'10�� Date TREEADMIN. Second Review: OApproved as revised. ElDenied. E]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date FIRE SERVICES Third Review: EJApproved as revised. DIDenied. E]Not applicable Comments: Reviewed by: Date:— Revised 05119/2017 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department 800 Seminole Road Atlantic Beach,Florida 32233-5445 Phone(904)247-5826 Fax(904)247-5845 E-mail: building-deptil Date routed: City web-site: http:1/www.Wab.us ki Rylt APPLICATION REVIEW AND TRACKING FORM Property Address: Wpi`V Ave- Department review required Yes No EVC B� Jill d" lannlnq� Applicant: CbMplrghelislye, &Zonln me�onmmsmator IV-ublic Works Project: Rcmov� Public Utilities Public Safety Fire Services Review fee $ Review Other Agency Review or Permit Required of Pemi Date Florida Dept.of Envisnartmental Protection Florida Dept.of Transportation --itJohns River Water Management District Amy Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: VApproved. [-]Denied. E]Notapplicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed bar Date: TREE ADMIN. Second Review: E]Approved as revised. ODenied. ONotapplicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: E]Approved as revised. DiDenied. E]Not applicable Comments: Reviewed by: Date*- Revised OW1912017 Building Permit Application Updated 12/8/17 City of Atlantic Beach 800 Seminole Road,Atlantic Beach,FIL 32233 Phone:(904)247-5826 Fax:(904)247-5845 Job Address: Permit NumberbWeL Legal Destriptior��w&A %\Pr4il -%.t? 0- —RE#_ Valuation of Work(Replacement Cost)$ IVI'llib Heated/Cooled SF_Non.Heated/Cooled • Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Windo./Door ��o — • Use of existing/proposed structure(s)(Circle one): Commera.al \Residential • If an existing structure,is a fire sprinkler system Installed?(Circle one�yes No LNaA • Sulinnit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal 7�the type of work I to be performec1:,J,...,T- 7"�� Florida Product Approval If NIA for multiple products use product approval form Prooertv Owner Information I N �!*- 4.LA4L,&- Address, C17 tate%Vk Zip Phone N0.1 E­Mail�-`, AM�43"14L- l\W &-3tW—,!S - G�Pfli Owner or Agent(If hgent,Power of Attorney or Agency Letter Required) NAIAIJ Contractor Inform t on Name of \"G- 'S6ILWic1*- Qualifying Agent:jLV&L4&i Address PA, city t -Zip''I"1-6'r Offil,�Phone Job Site/Co OL State Certification/Registration 121scillf-1. E-mail W-SACAmid A60 C 4611 Architect Name&Phone If Engin"i's Name&Phone i Workers Compensation Exempt/Insurer I LeasetEandmeas I 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 lam 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.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 cou n ty,and there may be additional permits required from other governmental entities such as water management districts,state agencies,or federal agencies. OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY LT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTE ID 1,9 ]BTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE --D G 0 R IN Y UR NOTICE OF COMMENCEMENT. TOP tr (Signature of Owner or Agent) (Signature 'Z Zi U (including contractor) co Ed and sworn to(or affirmed)before me this day of �igned and sworn to(or affirmed)before me this��da 0. by by�, at�n by Signature of Notary) Notary) LiZ..e..61,ifersonally Knmem OR I ]Personally Known OR AOFProduced Identification JYf5roduced Identification Type of ldentification! i�\- �'�.q. 'cc Type of Identification: R\. 2 c,* REVOCABLE ENCROACHMENT AGREEMENT REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach,Florida,a municipal corporation -gv,anizqd and exi=r the laws of the State of Florida,hereinafter referred to as"CITY"and -��4 of Atlantic Beach,Florida,hereinafter referred to as"USER". WITNESSETH: That die CITY does hereby grant the USER permission on a reveamble 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--Z�CftAq6rL--w4lL Any facility maintained, repaired, erected, andlor installed 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 USER shall be given by certified mail, retain receipt requested,to die following address • In the event it is necsessary for the CITY or the City's approved representative or other franchised utility to enter upon the above described casemsm or property of the CITY,the USER shall replace at the USER's sole expense, any and all material necessarily displaced during the action of maintainin&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 landiuse and code requirements of the CITY,including City Code Section 19-7(h) which states"Driveways that cross sidewalks: City sidewalks my 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 my chainges from the approved plans and/or method,most obtain written approval from the City of Atlantic,Beach Public Works Depar-ftnent,for said change wi thin 30 days after the day of completion. • This permit shall inme to die 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 locale requirements and we limitations/requirennents of egisements,public right- of-ways and other public land. USER further agrees that the CITY end its officers and employees shall be saved harmless by the USER from my of the work herein under the terms of this pernin and that all of said liabilities are hereby assumed by the USE& 4uzo-�— Dat Prophe�OwVgent(signed in presence of Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL -et The foregoing instrument was acknowledged this__X��day of XQQI� 20 \ by r Ce-\ who personally appeared before me and ;��.n �,of Signer) acknowledged aent volumarily se in it. c=ngwm*GGIa755I Eon,,JkJy 16,2022 0 .: �,�,f Notary Public,State of Florida Department Approval: Personally Known Produced Identification(Type)�y\ Scott Wilrialks,linblicv,07ki 15 0� irector Kaylc Moore,Public Utilities Director H.Waster Forms\Pubhc�Uflflties Works FOrms\R�axable Encroachment Agreement 2.5.18.docx ReVision Date:2/5/18 RIGHT-OF-WAY/EASEMENT PERAHT Permit#Issued by the City of Atlantic Beach PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND ORTAE41NG UTILITY LOCATES Job Address VA awrA, k14— Phone Pennift, Email ��tkzW JJIA&LfWk-Laq Requesting Permission to Construct —1�cxsift Location(Refierence to Cmss-Stmt)-I#4 -&*A k,� —tww1w L;"r' 4 -T" • Permittee 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 m relocation of all,or my portion of mid street or easement as determined by the Director of Public Works, my or all said poles,wires,pipes,cables or other facilities and appurtenances authorized hereunder,shall be immediately removed firain said street or camment or rcset or relocated hereon as required by the Director of Public Works and at the expense of the Pennittee unless reimbursement is authorized. • All work shall meet City of Atlantic Beach okF_Iorida Department of Transportation Standards and be performed under the supervision of (Project Superintendent) z4�k k e—C) with Company Nam���-49�,OF4:�F�U-- Phonejb4�6'(A • 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 ali practical,in keeping with City specifications and the roamer 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. Calculations sliming any increase in impervious area on owner's lot or in the City right-of-way are to be included with this application. • The pennittee shall commuce actual construction in good faith within_days. If the beginning date is more than 60 days from date of permit approval then perinittee must review the permit with the Director of Public Works to make am no changes have occurred in the men,that would affect the permitted construction. • It is understood and agreed that the fights and privileges herein set out we granted only to the extent of the City's right,title and interest in the land to be entered upon and wed by the holder,and the holder will,at all times, assume all risk of and indemnify,defend and save harridess the City of Atlantic Beach from and against my and all loss,damage and cost of expenses ansing in my manner of the exercise or attempted exorcises by the holder of the aforesaid fights and privileges. • The D rector o Pu mks shall be notified twenty-four(24)hours prior to starting work and again i is upon omple n. 06 Purnmee(signed in presence of Notary Pliblic) STATE OF FLORIDA,COUNTY OF DUVAL The foregoing instrument was acknowledged this�\\-\ day of 20 by whopersonally appearedbeforeme and (printed mine of Penuittee) acknowledged at shes no the instrument volurnarily for the purpose expressed in it. 4 —2 Personally Known g�.m.—.f Notary P-01c,State of P Torida Produced Identification�Crype)i��' �, 19 ALYSUStryll IGGIO7551 i,)COMiNiDn e Expinis July 16,2022 ri 0- 0 oh� CFL o 4O.-VON > NN Q 0 9 0 0 x Goom 30N33 C— at io-I Jo 0 JSV3 3HI �::E 0 0 z 0.8 00 Y. V) GVd 3/y -M -10 �i �1300 -0 313 03 T CO .r� -P, C,Z tQ L4 (A col C) 0 ON ;;a U) m '-4 w O� OD 00 o 70. -n 0 ZA rn A m 7z ca m Z� 0 0 ;—o 00 rri ;;o > -----7w czt Z Z bo 00-0- L r o o 0 N. w �?;- > 90 3k3b9W 60 1,000--V (1-131J J(009 jgvo�l '3n , TREE &VEGETATION AFFIDAVIT FOR INTERNAL OFFICE USE ONLY City of Atlantic Beach PERMIT#_ Community Development Department 800SendnoIeRoad Atlantic Beach,FL 32233 (P)904-247-5800 SITE INFORMATION ADDRESS SUBDIVISION BLOCK LOT RE# RESIDENTIAL E] COMMERCIAL OTHER APPLICANT INFORMATION NAME"-k�j�� PHONE# 0l0q- 601--L615 ADDRE55 —t>�� CELL# CITY —b4.J�, STATE S;A ZIP CODE EMAIL7::��*6-\65- JJLP �9OWNER LEGAL AUTHORIZED AGENT I 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 Florida and/or I have participated in a pre- application meeting with the Administrator of those regulations. Subsequently,I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed from the above-described property and/or adjacent properties including right-of-way. IN 7EBYCERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT:Signature ofPropeny Owner(s)or Authorized Agent �v- &�� —Jl� Z�--�50 — 1 -,7-4 — 'd1141tk IICNATr)OF APPLICANT PRINT OR TYPE NAME DATE SIGNATURE OF APPLICANT(2) PRINTORTYPENAME DATE Signed and sworn before me on this day of by State of County ofs��111'112� Identification verlfied:'�� oath Swom: E] Yes ,,,,A=LS:,ER =7GG��--$Sl e�,t, Sgnature Exom My 16,20, Exom My 16,20, ok", MyCornmisslon expirel�z�,��. C��, 04 TREE AVIT03.0?.2018 AW-15-2010 09:24 FRDtl:RF)NDY W RUDD 3525464744 TO:19042475845 PA RA-8-2818 12:33 FFMRANDY W RUDD 3585464744 MilgB43671757 P.1 U0,W6,16; 16,14 orrom; Ia:dIj*loqo*l%q I Moe Piz; -a �-&lz 6,Involl v idusslff� I Wtma M MbWMv4WMWMvMW�b�MOIR, 10 COMMIMId"T.�m ;=Pftph AM oft4am f-4 orwo�"..rurrmwoudI, O� ao Ja-� X2 Aann � x CA�.i A u K" Ct L�D Owraft J�I., gnmIum No" �—In W UP 0.*Idw 1861530MM57t. AM" Bait Serin a, FL.32 �N ��Fftft Aftion. ---------- PkftNo, MN& Kwo Adamidl Phow ft FWW. oomnwft,mbqNrAd: Rolm FBI No SKwn 713AS M M),PaW (M In K�rs pp". Fnft Of MON q, tow.* �a�A"FDA"GoRu".0 Mae Q"V Rim �ft 0 DM*201819145ZORBK18491 PWlW6, NumbvPom:l RecmWIM1401001:54PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 PDENA R�A�Y 2018