1505 SELVA MORENA DR RESO-17-0036 Revision Request/Correction to Comments "ALL INFORMATION
L�rHIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
v� 800 Seminole Rd, Atlantic Beach, FL 32233 j) /
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 9 �/ -E/0.��J
QRevision to Issued Permit OR El Corrections to Comments Date:_1 Z 1 1
Project Address: 1 l" -4 `J�40AeV.— (,\YL
/ � n
Contractor/Contact Name: (,., 3:1
` V� A&S cyll-N,
Contact Phone: � ' VIAEmail: V
Description of Proposed Revision/Corrections:
J�Ve wur'�
P A k A ' M
I affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• W' 1 proposed revision/corrections add additional square footage to original submittal?
No ❑✓_ Yes (additional s.f.to be added: )
• i proposed revision/corrections add additional in se in buildi g value to original submittal?
FV *Yes (additional increase in building va e )(contractor must sign if increase in valuation)
*Signature of Contractor/Agent:
(Office Use Only)
Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due$
Revision/Plan Review Comments
Department Review Required: ) /
Building ECEIV
Planning&Zoning Reviewed By
Tree Administrator DEC 10 2018
Public Works
Public Utilities '�r0
Y
Public Safety BDate
Fire Services Updated 10/17/18
REVOCABLE ENCROACHMENT AGREEMENT
' r "ALL INFORMATION
City of Atlantic Beach
HIGHLIGHTED IN CRAY
800 Seminole Road, Atlantic Beach, FL 32233
IS REQUIRED.
REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation organized and
existing under the laws of the State of Florida, hereinafter referred to as "CITY" and
Lori Gaglione&Patrick Nall 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 Brick border along driveway in Right of way
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to
relocation or removal on thirty(30)days' notice by CITY to USER,said notice to USER shall be given by certified mail, return
receipt requested,to the following address 1505 Selva Marina Dr Atlantic Beach,FL 32233
• 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
"—Tabilities are hereby ss med by th ER.
P) 1 6" Dade
Pro rt caner ent (s' ne in proe e o Notary Public)
STATE OF FLORIDA, COUNTY OF DUC1
The foregoing instrument was acknowledged this day of C 20 ,S ,
by L O`f't G O19 I Ione- who personally appeared before me and
(printed name of Signer)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
J ary P►o S HERSHEY
Notary Pudic,State ofFbrlda DepartmentApprQval:
fomdsdoO GG 252584
Signature of Notary Public,State of Florida Aycoinm.rlimA%26,2022
[ ] Personally Known
i
�,Kroduced Identification(Type) Scott Williams, Public Works Director
H:\Applications&Forms\Word Documents\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18