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1639 Sea Oats Dr ROW18-0030 driveway permit •r51-11 fl J CITY OF ATLANTIC BEACH s' 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 RIGHT OF WAY - SINGLE OR TWO FAMILY RIGHT OF WAY MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: ROW18-0030 Description: Driveway Estimated Value: 0 Issue Date: 9/18/2018 Expiration Date: 12/17/2018 PROPERTY ADDRESS: Address: 1639 SEA OATS DR RE Number: 172020 0136 PROPERTY OWNER: Name: COLLIER KEITH D Address: 1639 SEA OATS DR ATLANTIC BEACH, FL 32233-5827 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: 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. 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 Page 1 of 2 Enter Permit Number ROW 18-0030 View Report J.) 4 E:::]of 2 P P� � 100% x/ � Find I Next ilet Permit Conditions City of Atlantic Beach Permit Number:ROW18-0030 Description:Driveway Applied:7/25/2018 Approved:9/10/2018 Site Address:1639 SEA OATS DR Issued:9/18/2018 Finaled: City,State Zip Code:Atlantic Beach,FI 32233 Status:ISSUED Applicant:<NONE> Parent Permit: Owner:COLLIER KEITH D Parent Project: Contractor:<NONE> Details: LIST OF CONDITIONS SEQ REQUIRED SATISFY NO ADDED DATE : DATE DATE TYPE : STATUS DEPARTMENT: CONTACT: REMARKS 1 7/30/2018 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 247-5834. 2 7/30/2018 METER BOX SEWER CLEAN OUT INFORMATIONAL PUBLIC UTILITIES Kayle Moore Notes: Ensure all meter boxes,sewer cleanouts and valve covers are set to grade and visible. 3 9/10/2018 DRIVEWAY APRON INFORMATIONAL PUBLIC WORKS Scott Williams Notes: All concrete driveway aprons must be 5 inches 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. 4 9/10/2018 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(904-247- 5814)to request an Erosion and Sediment Control Inspection prior to start of construction. 5 9/10/2018 ON SITE RUNOFF INFORMATIONAL PUBLIC WORKS Scott Williams Notes: http://atlanticbeach.trakit.net/trakit/DocumentV iewer.aspx?&report=/Documents/PERMIT... 9/18/2018 Permit Conditions Page 2 of 2 All runoff must remain on-site during construction. 6 9/10/2018 POST CONSTRUCTION TOPO INFORMATIONAL SURVEY PUBLIC WORKS Scott Williams Notes: If on-site storage is required,a post construction topographic survey documenting proper construction will be required. All water runoff must go to retention area and retention overflow must run to street. 7 9/10/2018 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. 8 9/10/2018 RIGHT OF WAY RESTORATION INFORMATIONAL PUBLIC WORKS Scott Williams Notes: Full right-of-way restoration,including sod,is required. �xrRy Printed:Tuesday,18 September,2018 NMGT loft http://atlanticbeach.trakit.net/trakit/DocumentV iewer.aspx?&report=/Documents/PERMIT... 9/18/2018 City of Atlantic Beach APPLICATION NUMBER s� Building Department (To be assigned by the Building Department.) 800 Seminole Road l,1 Q r� Atlantic Beach, Florida 32233-5445 JUL 262013 90yV ' Phone(904)247-5826 • Fax(904) 247-.5845 -1 2 s E-mail: building-dept@coab.us Date routed:�_;'� City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: I �61- 05t Department review required Yes No �� B " Applicant: T4c ae owti f Planning &e A mZonm t�JTreinistrator ProjectI ` v WaFu��_ ublic Utilities ubIii c Safety Fire Services Revlew<fee _ ®etSl na 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 � l �� Reviewed by:�" Date: TREE ADMIN. Second Review: ]Approved as revised. ❑Denied. JZNot applicable PU C CWORKS Co ents: UBLIC UTILITIES PUBLIC SAFET 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 APPLICATION NUMBER JSP Building Department (To be assigned by the Building Department.) 800 Seminole Road �Q Ol,' ' OO Atlantic Beach, Florida 32233-5445 1Q !9yV Phone (904)247-5826 - Fax(904)247-5aWL 2 6 2018 7 2 S E-mail: building-dept@coab.usDate routed: City web-site: http://www.coab.us BY_ APPLICATION REVIEW AND TRACKING FORM Property Address: 141 31 Sect ca:7� Department review required Yes No Building Applicant: Tt 0 mey wn er Planning &Zoning Tree Administrator Project:ri yr— 11J& �-�ub—hc_Utilities_) ubli ublic 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. E06enied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING ► Reviewed by: Date: � TREE ADMIN. Second Review: Approved as revised. ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed b Date: -� FIRE SERVICES Third Review: ❑Approved as revised. [—]Denied. []Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 MAP SHOWING BOUNDARY SURVEY OF LEGAL PROVIDED BY CLIENT: SE LOT 10, BLOCK 5, SELVA MARINA UNIT NO. 6, IV � RMCHT(,SG -S pR ACCORDING TO PLAT RECORDED THEREOF IN PLAT ,, I�r BOOK 34, PAGES 51, 51A, 518 OF THE CURRENT 4`3.2wH''J/+C PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. AND IT�AT�PORTION OF TR CTHE PLATVTHEREOFA 'CHO��X44 F-A))IB' RECORDED IN PLAT BOOK 34, PAGES 51, 51A, )(,yfgS 51B, OF THE CURRENT PUBLIC RECORDS OF 00 URFp DUVAL COUNTY, FLORIDA THAT LIES SOUTHERLY L / 7418•(GHORD)(PLAT) OF THE EASTERLY EXTENSION IN A STRAIGHT LINE `7s.23- 7422 (cHORD)(MEASURED) OF THE NORTHERLY BOUNDARY LINE OF LOT 10, Pr BLOCK 5 OF SAID SELVA MARINA UNIT NO. 6. 11 \. 0.4' 11 CERTIRED TO: KEITH D. COLLIER & JENNIFER COLLIER —,b. 1 MEGASTAR FINANCIAL CORPORATION 11 �� "EsrR,A'LDNG 1 HOMEGUARD TITLE & TRUST, LLC P ? UNE FIRST AMERICAN TITLE INSURANCE COMPANY O� L/ E.N 2 RY. S>FpS ^^ of �y m I W LU ry ,,,, m I a ^�� 14.8' LOT 9 Ia 7 BLOCK 5 / SP(Ir W a 0.2' �O.t• POS jSRICK I'£C ED 0639 I I M o A/CO b / PAD .• I 1 1 of f�� • i " S.J. m C0 4/ 0.0' F � 6• P4 I'Df0 /\O-AD I I ?P tv0 0' 40 2i0.. ti E 4 24'O " CK O • 1 g R0 I /• IfB t.g t LOT 11 tM o BLOCK 5 O h' yJ 00-114 O I \ ka `a fMpD cMn o {.4 p ox 4.4* \ STEPS 1 I J,°• � LOT 10 99• BLOCK 5 N 10'EASEMENT FOR h DRAINAGE&UTILITIES 'o. / p, i � I 1.2 i P 2 '� 1A57g /moi � F Ctc^Gy n ';�A 5� R P�•�0 s s z ° c 13 2 LOT 5 m a R / / 1T q3 g9 BLOCK 5 9 F / a 506 49 Dl M�PSV 9 22 S 5228 `C(TLP S ICNOR`n' clC RQ PO LEGEND: SEM�NQSET 12-REBAR "At O Nc�g0)O •STAMPED PSlI/61{8 PC = POINT OF CURVATURE ��0,1NtY a FOUND 1/2 IRON PIPE Pi POINT OF TANGENCY A.C NO IDENTIFICATION PRC POINT OF REVERSE (UNLESS OTHERMISE NOTED) CURVATURE =4'.4'CONCRETE MONUMENT PCC PONT a COMPOUND A/C = MR CONDITIONER CURVATURE —z— FENCE O . CONCRETE NOTES: REVISIONS 1. BEARINGS ARE BASED ON THE __ PLIAT____BEARING OF __N_2 `17_`14_lY___ ALONG THE WESTERLY BOUNDARY LINE OF SUBJECT PARCEL. DATE DESCRIPTION 2 BY GRAPHIC PLOTTING ONLY THE CAPTIONED LANDS LIE WITHIN FLOOD ZONE _ _'_x___, AS SHOWN ON THE 06'09-16 UPDATE NATIONAL FLOOD INSURANCE MAP DATED JUNE 03, 2013, COMMUNITY NUMBER 120075. PANEL --40-d- 3 THIS SURVEY REFLECTS ALL EASEMENTS&RIGHTS OF WAY AS PER RECORDED PLAT&/OR TITLE COMMITMENT IF SUPPLIED. UNLESS OTHERWISE STATED, NO OTHER TITLE VERIFICATION HAS BEEN PERFORMED BY THE UNDERSIGNED 4: THIS SURVEY IS NOT VALID WITHOUT AN AUTHENTICATED ELECTRONIC SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL. JOB # 19040-A DATE OF FIELD SURVEY: 4-5-2011 1 SCALE: 1" = 30' Ray Thompson CERTIFICATE I HEREBY CERTIFY THAT THIS ROESTJY DE UNDER MY RESPONSIBLE CHARGE SURVEYING, Ine. AND MEETS THE MINIMUM T AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIO L 5 AN S CHAPTER 5J-17,FLORIDA Going the DISTANCE for You ADNINIS RATI E C C ANi �QON 4 LORIDA STATUTES. 1825 University Boulevard West Jacksonville,Florida 32217 o RAYMOND THC MPS (Phone)904448-5125 R11 STFRED SUR OR ANiNIN BPPER I. STATE OF FLORIDA (Fax) 904448-5178 L SE BUSINE�,S 7469 LAND SURVEYS 0 CONSTRUCTION SURVEYS R RH BDIVISIONS THIS DRAWING IS AN INSTRUMENT OF SERVICE AND IS THE PROPERTY OF DESIGN COOPERATIVE,LUL AND IT SIW1 NEVER BE REPRODIAED IN WHOLE OR IN PART WM40UT TIE EXPRESS WRMTN PERMISSION OF DESIGN COOPERATIVE,LLC ,Rd) RN&01�1.19\nO�1\ 1193 ow,1O I0 ON\W35 �Oti3' - i/ Ix 5� PY. 5A u \\ 25 I I I I \\ I ma I I r I ° / I I ° DENIED I j I j I ❑ , ` i 4rneov-)r\e1rs lIaue �atreckd� reeeivQ c� ct va✓\o+.hC4 pra " GL c i r C 1Ai 0Cr car ve CLx 6o D Ali I' g� g 0 z COLLIER RESIDENCE CITY OF ATLANTIC BEACH 800 Seminole Road 2ni�3 AUG 3 Atlantic Beach,Florida 32233 = by-__. REVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS QQ Dat�J z Mo Revision to Issued Permit Corrections to Comments. J Permit o',J M36 Project Address Contractor/Contact Name Phone � 5' `jrij f d Email Description of Proposed Revision/Corrections: Permit Fee Due $ 0ZW S 7 7;1- Alaf/ 1 Q / //''G< CSG Q � r /a Y /�� t G 69r O Glr l y /' / "S��' "0 AT2 r3 re. �y py (� l of 10A—)'J a was r� A tion ncrease in $ ditiona By signing below, I lel/t rl✓ ( / affirm the Revision is inclusive of the proposed changes. ( rinted name) Signature of Contractor/Agent(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 Planning & Zoning Reviewed By Tre ministrator Public W Public Utilities ✓ ✓ Public Safety D 4fe Fire Services j- J; CITY OF ATLANTIC BEACH Department of Public Works .f ;? 1200 Sandpiper Lane Atlantic Beach, FL 32233 (904) 247-5834 PUBLIC WORKS PLAN REVIEW COMMENTS Date: 8/2/18 Applicant: Keith and Jennifer Collier Permit#: ROW18-0030 Email: hastie@keithcollier.com Review Status: DENIED Site Address: 1639 Sea Oats Drive THIS PLAN REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS Correction Items must be submitted to the Building Department at 800 Seminole Road. Submittals that respond to only one or a few correction items will not be accepted. Revisions may not be submitted until ALL departments have completed their respective reviews. Revisions must be submitted to the Building Department and must respond to EACH department review. PUBLIC WORKS CORRECTION ITEMS: • A Revocable Encroachment Agreement must be submitted. • Provide a detailed plan of water retention area and how water runoff gets to water retention areas and then to street. • Back driveway cannot extend into Seminole Road drainage easement. APPROVED • Provide a new plan showing driveway not extending into back right-of-way. PUBLIC WORKS CONDITIONS OF APPROVAL: (The following comments will be printed on your permit as Conditions of Approval) • 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. • 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. • All runoff must remain on-site during construction. • If on-site storage is required, a post construction topographic survey documenting proper construction will be required. All water runoff must go to retention area and retention overflow must run to street. • 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. • Full right-of-way restoration, including sod, is required. • All runoff must remain on-site. Cannot raise lot elevation. • Maximum driveway width within the City right-of-way is 20'. • Must provide a topographic (TOPO) survey with water retention for final C.O. Inspection. Scott Williams, Public Works Director swilliams@coab.us/904-247-5834 Page 1 of 2 O:\Public Works\ADMIN\PLAN REVIEW COMMENTS\ROW18-0030(Owner-Collier).docx A Resubmittal Notes: All revisions and changes shall clearly stand out from the rest of the drawing on the sheet as a revision by way of completely encircling the change with "clouding". The revision shall also be identified as to the sequence of revision by indicating a triangle with the revision sequence number within it and located adjacent to the cloud. The revision date and revision sequence number shall also be indicated in a conspicuous location in the title block for each sheet on which a revision for that sequence occurs. For projects still in the initial review stage and permit pending, all sheets with revisions shall be inserted into each set of drawings. The original sheets must be clearly marked "VOID" but are to be left within the set of drawings. Complete new sets of drawings will not be accepted ADDITIONAL ITEMS MAY BE REQUIRED DEPENDING UPON NEW INFORMATION AND CLARITY OF FINAL PLANS SUBMITTED FOR REVIEW. Page 2 of 2 O:\Public Works\ADMIN\PLAN REVIEW COMMENTS\ROW18-0030(Owner-Collier).docx SyL`J; City of Atlantic Beach APPLICATION NUMBER J3 � Building Department (To be assigned by the Building Department.) 800 Seminole Road \'' (� Atlantic Beach, Florida 32233-5445 JUL 2 6 203 ��yV ' �`30 Phone (904)247-5826 • Fax(904)247�145 2,S Q Ll E-mail: building-dept@coab.us Uy. Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: I �p 1 SE)2_ OAl- Department review required Yes No B Applicant: �omeoyjnf_r Planning &Zonin tTree ministrator Project. D 1�i v w ubli ublictilities ublic 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: KApproved. ❑Denied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by:�� ycDate: TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. ❑Not applicable PU WORKS Co ents: UBLIC UTGILITIES PUBLIC ET Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. [—]Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 RIGHT-OF-WAY/EASEMENT PERMIT Permit# Issued by the City of Atlantic Beach a w g" 6o3o PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES C� Job Address v039 Saa -}s -brNVe Phonee-535-,3498 or �(T7 W_55� /� Permittee Ke 4-to an J S vin i7 - Ir Co(l 1 e r Email hasli eO ke 4idCo l h e r.Cd-w) Requesting Permission to Construct Location(Reference to Cross-Street) • 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 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 immediately removed from said street or easement or reset or relocated hereon as required by the Director of Public Works and at the expense of the Permittee unless reimbursement is authorized. • All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of OenyLcr !� (Project Superintendent) with Company Name Phone • 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 manner 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 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 within_3d__bays. 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 righr,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 lass,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 startin work and again immediately upon comletion. Date Permittee(s' ed in presence of Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL �n lG The foregoing instrument was acknowledged this 2'� '" ' day of �1 ,20 by �C�>nV�t C1�/ l �„�Q✓ ,who personally appeared before me and (printed name o Permittee) acknowl ed that he/she sig d the instrument voluntarily for the purpose expressed in it. %, r__�/ Personally Known Si ature of Notary Publ' , of F rida Produced Identification(Type) LISA FRISBY *®*= Commission a GG 92360 My Commission Expires April 10, 2021 REVOCABLE ENCROACHMENT AGREEMENT REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation . d an xist>n n the laws of the State of Florida, hereinafter referred to as"CITY"and ?F , /��/0" 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 for the purpose as described in the City of Atlantic Beach. This work is generally described as ek4 Any facility maintained, repaired, erected, and/or io4talled in the exercise of the privilege granted remains subject to relocation or removal on thirty(30)days' notice TY to R, s ' n i USER h be2t�o 4UWL C, en b ertifie mail, return receipt requested,to the following address • 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 easement 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 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." • 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 easements, 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 operty ner/Agent(signed in presence of Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL The foregoing instrument was acknowledged this day of , 20 , Y��f(/J� ,who pe ally appeared before me and inted name of Signer) ackno 1 ged that he igned th instrument voluntarily for the purpose expressed in it. Signature of Notary Public, State of F r a Department Approval: Personally Known Produced Identification(Type) " TONI GINDLESPERGER 4 "s' colt 1 li s Public ors hector ,- MY COMMISSION#FF 924951 ' 'a EXPIRES:October 6,2019 O:\Public Works\ADMI R8[Yj2 E86fAba411!lN�dBc Revision Date:8/31/18 -%�> TMLS DMWDIG IS AN INSTRUMENT OF SERVICE ANO IS TME PROPERTY OF DESIGN GOOPEMTIVE,LLC AND IT SMALL NEVER EL REPRODUMD IN WHOLE OR IN PART WIFMOUT TME E SS VMITTEN PERMIWON OF DESIGN COOPEMTIIE,LLF.. IST 99 NO u USM Aol 39 moo' AY1(oTT �Z2g to a�Y0 0 TS I g I � o \\ I f I / I / I I // It I 1 / APPROVED O 9 m p z y COLLIER RESIDENCE