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805 PLAZA DWAY18-0008 PAVER DWY PERM DRIVEWAY PERMIT PERMIT NUMBER �. DWAY18-0008 CITY OF ATLANTIC BEACH ISSUED: 3/26/2019 800 SEMINOLE ROAD EXPIRES: 9/22/2019 0ii19" ATLANTIC BEACH. FL 32233 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL •RK MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' D+ BUILDING CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY. 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. JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK: 805 PLAZA DRIVEWAY SINGLE OR TWO PAVER DRIVEWAY $8000.00 FAMILY DRIVEWAY TYPE OF ZONING: :D • • • GROUP: 171115 0000 ROYAL PALMS UNIT01 • ADDRESS: THE ENHANCE COMPANIES 2120 ROMEO POINT IANE FLEMING ISLAND FL 32003 • ADDRESS: AUGUSTINE MI YOUNG LEE 805 PLAZA ATLANTIC BEACH FL 32233-3809 WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR 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. LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. I 1 PUBLIC WORKS DRIVEWAY APRON INFORMATIONAL 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 PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL 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. Issued Date:3/26/2019 1 of 2 �,ow..�...,�,..,.�w..._,.�......... .,..-__...,�.._>....,.......�..a...�...,.�....,.an. ...-_.,........,... a,...,.......—.—,..�,.s„h,....,....................da,.........,.,e,.�.,...®.,,_,,,a.,.._..—.,...N..e..—.�..w.,�.,..,.b.. ,.-t DRIVEWAY PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH DWAY18-0008 8 ISSUED: 3/26/2019 00 SEMINOLE ROAD urtl°� ATLANTIC BEACH. FL 32233 EXPIRES: 9/22/2019 3 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. 4 PUBLIC WORKS POST CONSTRUCTION TOPO SURVEY INFORMATIONAL 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. 5 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL 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. 6 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. 7 PUBLIC WORKS MAXIMUM DRIVEWAY INFORMATIONAL Notes: Maximum driveway width within the City right-of-way is 20'. I DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.001 TOTAL: $25.00 Issued Date:3/26/2019 2 of 2 yes Pim INVOICE # City of Atlantic Beach INV-3521 F��l 800 Seminole Road Date Due: 4/25/2018 Atlantic Beach, FL, 32233 AUGUSTINE MI YOUNG LEE 805 PLAZA ATLANTIC BEACH, FL 32233-3809 Invoice Date:3/26/2018 Record# Record Type Fee Group Fee Description Quantity Amount DWAY18-0008 DRIVEWAY PUBLIC WORKS PLAN REVIEW PW REVIEW BUILDING MOD 0 $25.00 OR ROW $25.00 Invoice Total:$25.00 Please send your payment to this address: 00P Printed: Monday,March 26,2018 10:37 AM 1 of 1 �,r yCash City of Atlantic S) Beach • : • �•Ji3), DESCRIPTION • CITY PAID PermitTRAK $25.00 DWAY18-0008 Address: 805 PLAZA APN: 171115 0000 $25.00 PUBLIC WORKS PLAN REVIEW $25.00 PW REVIEW BUILDING MOD OR ROW 001-000,--329-1004 0 $25.00 TOTAL , . $25.00 Date Paid: Tuesday, March 26, 2019 Paid By: THE ENHANCE COMPANIES Cashier: CB Pay Method: CREDIT CARD 26358 Printed:Tuesday, March 26, 2019 10:58 AM 1 of 1 1 J PLAT BOOK 30 PAGES 50-60+4 OF THE CURRENT Pu&x RECORDS OF DWAL COUNTY, FLA CERTIFIED TO: JAMES AUGUSTINE ZZh 00 b Y 1 ti U -'m BL L O T 1 0 cx� '� ' 0 0 1o• �AXVAc - � UTq,l E EASEMENT r SM42OP02NE t- o SET -- ri e-now FDWM x7.4• — ---- .� �_) ----•;-, x Iwo — 7.3' SHED L 0 T 2 5 ` D r-ex .a 7' 8 l O C K i'4ai n^ �- �2 o. Olt p x nn 4•Y4• CaIIC 24.7 *jc PAD j Over' I�c c �� •.t. �w N N S w4 U l ,a 5 O"sruc o Y C'4PIT O ` RESIDENCE AVWMW PA a U Ne f ; APPRDVtD a3 s k►. � Z �p C7 WgL 4.7' D' 9 VV77 2S 8 R.l. PER PLAT _ �' _2 .'r ) X-----. __ r} N N 574E 241.95• IE C; BASE) N '37271W 80.65' PWA (60. RIGHT OF "Ay) APPROVED City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road 1 Q' /, Atlantic Beach, Florida 32233-5445 ` V v0(J Phone(904)247-5826 • Fax(904)247-5845 oil E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: C� P(—.rA:�'A Department review required Yes No �— Building Applicant: Cto RiucNC_ COCA anning &Zoning vree minis rator Project: �C' (� ublic Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receiptof Permit Verified B Date Florida Dept. of Environmental Protection C'X Florida Dept. of Transportation V 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 Reviewed by:'�e Date: TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑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 "!01119" REVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS Date 34, 1 Id Revision to Issued Permit Corrections to Comments_ Permit# D U v 000 8 Project Address Uy Contractor/Contact Name �k2 �+� Q "! J' Phone 6109-21% — �'7^i 71 Email_ ATJ @ ew6,vle-P Description of Proposed Revision/Corrections: Permit Fee Due$ Additional Increase in Building Value$ Additional S.F. By signing below,I affirm the Revision is inclusive of the proposed changes. (printed name) Signature of Contractor/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: �j�--- Building CPlati onin Reviewed By Tree Administrator ublic Wor<s 3�Z �— •hies-_.. Public Safety Date Fire Services Building Permit Application Updated 12/8/17 City of Atlantic Beach MSIR ? 800 Seminole Road,Atlantic Beach,FL 32233 Phone:(904)247-5826 Fax:(904)247-5845 mos Pla a Job Address: � Permit Number: Legal Description RE# Valuation of Work(Replacement Cost)$ IT 1511� H,eated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition("' Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No 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: 9- o\ADr;f-,)a y W Qa t r 5 Florida Product Approval# for multiple products use product approval form Property Owner Information 5 PDQ Name: AV4 u k►^P Address: City B State —�— Zip 32,233 Phone ' 904 — '?f& 7 E-Mail t Cv Owner or Age gent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company: -FlAe IFA rgKCP Qualifying Agent: 4�-�0►J;G� �`�'�d Address ZtZv 90.1,e4-� P+ City (-lt,,ni rvt I State [_ Zip 32003 Office Phone clol.216, 7171 Job Site/Contact Number `104 .,ML . 7 111 State Certification/Registration# C QL (32 q7L}3 E-Mail Q6.cA(PJ L*4-4Ace co I nbeS •to, Architect Name&Phone# Engineer's Name&Phone# Workers Compensation We- PEO 000 92? 0:3 of T Exempt7/Insurer/Lease Employees/ xpiration Date Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or instal lation 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. 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. 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 RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNE7BE ORE RECORDING YOUR NOTICE OF COMMENCEMENT. " v (Sign re of wner or Agent) (Signature of Cont inclu contractor) Signed and sworn to(or affirmed)before me this 3 day of Signed and sworn to(or affirmed)before me this day of CL(L"ks �Sk, p d C r W MY COMMISSION#GG 042984 MY COMMISSION#GG (Sgn tre oNotary) '%J �o� �� iuf 5 Pupkc Pgnature of Notary) �yrrr 8w4W llru Nowy Pubko lhid• 8olld•d ThN Notuy ]Personally Known OR [ ]Personally Known OR �A Produced Identification [413roduced Identification p Type of Identification: F�- d(o V L-t\S `,(_e.aS-t Type of Identification: 1.0'VPCity of Atlantic Beach APPLICATION NUMBER �s Building Department (To be assigned by the Building Department.) r 800 Seminole Road MAR 5 2018 j g _OU v� Atlantic Beach, Florida 32233-5445 , Phone(904)247-5826 • Fax(904)247-5845 a 'vJ;i �� E-mail: building-dept@coab.us Date routed: �S City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: �� L � Department review required Yes No y Building Applicant: Cy1 anning &Zoning e AdMinistrator Project: ec'uw ublic Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receiptof Permit Verified By Date 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 r Reviewed b Date: TREE ADMIN. Second Review: [/Approved as revised. ❑Denied. []Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES r PUBLIC SAFETY Reviewed by: Date:2' FIRE SERVICES Third Review: []Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 s CITY OF ATLANTIC BEACH n� 800 Seminole Road s MAR 2 2 2018 Atlantic Beach,Florida 32233 i REVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS Date 3 2-1 ) I Revision to Issued Permit_ Corrections to Comments_ Permit# D(-oA C9 Doo 8 Project Address p��J T t Ct 2:9� Contractor/Contact Name ke G h "e < L)ttJdld -- Phone " I0q-2�, !"�^� "') Email 0�k✓i� @ QdL►�Pbw` ,pS . C0w� Description of Proposed Revision/Corrections: Permit Fee Due$ RQ -e �Jf tri t hPatO&C,'tee � S Additional Increase in Building Value $ Additional S.F. By signing below,I affirm the Revision is inclusive of the proposed changes. (printed name) Signature of Contractor/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: \ Building 7 an onin eviewe y ree Administrator ublic Wor Public Safety Date Fire Services ' •7 S CITY OF ATLANTIC BEACH ,J s Department of Public Works 1200 Sandpiper Lane Atlantic Beach, FL 32233 (904) 247-5834 PUBLIC WORKS PLAN REVIEW COMMENTS Date: 3/16/18 Applicant: The Enhance Companies Permit#: DWAY18-0008 (DENIED Paver Driveway) Address: 2120 Romeo Pt. Lane Site Address: 805 Plaza Fleming Island, FL 32203 Email: iauggy(a�hotmail.com /I PPYapppplLica_tion' Email: david(u�enhancecompanies.com APUBLIC WORKS CORRECTION ITEMS:(Submit the following in orderfor us to approve y or tlhe`Public Works Department) • Provide construction site management plan including location of silt fence, dumpster, portable toilet. Right-of-way Permit is required if using right-of-way for construction parking. • Provide drainage plans showing site topography (flow arrows, etc.). • Provide erosion and sediment control plans with installation details. • Section 24-66(b) of the Land Development Regulations requires on-site storage for increased run-off if adding 400 SF or more impervious surface. Provide Delta volume calculations and on-site retention required per Section 24-66(b). • Provide a pre-construction topographic survey prepared by a Florida Licensed Professional Land Surveyor, showing 1' contours. • Provide a detailed plan of water retention area and how water runoff gets to water retention areas and then to street. • Concrete sidewalk must continue through driveway. • Provide the type of work that is being done in the right-of-way; from sidewalk to street. 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 an 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. • Maximum driveway width within the City right-of-way is 20'. Page 1 of 2 Scott Williams, Director of Public Works swilliams�a coab.us /904-2.37-5834 THIS PLAN REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS Any plan change must be submitted as a Revision to the Building Department at 800 Seminole Road. Revisions may not be submitted until ALL departments have completed their respective reviews. Revisions submitted MUST respond to EACH department review. Submittals that respond to only one or a few correction items will not be accepted. 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 Comp. By: S/W Date: 3/16/2018 `BJH Public Works Department City of Atlantic Beach Permit No: DWAY 18-0008 Address: 805 Plaza Required Storage Volume Criteria: Section 24-66 of the City of Atlantic Beach's Zoning, Subdivsion, and Land Development Regulations requires that the difference between the pre-and postdevelopment volume of stormwawter runoff be stored on site. Volume of Runoff is defined as follows: V=CAR/12 Where: V=Volume of Runoff C =Coefficient of Runoff A=Area of lot in square feet R=25-yr/24-hr rainfall depth (9.3-inches for Atlantic Beach) Predevelogment Runoff Volume: Lot Area (A) = 7,904 ft' Runoff Coefficient Area Lot Area Description (ft) (ft) "C" Wtd"C" Impervious 2,284 7,904 1.00 0.29 Pervious 5,620 7,904 0.20 0.14 Runoff Coefficient(C)= 0.43 Runoff Volume V= 0.43 x 7,904 x 9.3 / 12 V= 2,641 ft3 Postdeveloament Runoff Volume: Lot Area(A) = 7,904 ft2 Runoff Coefficient Area Lot Area Description (ft) (ft) "C" Wtd "C" Impervious 3,060 7,904 1.00 0.39 %ISA= 38.7% Pervious 4,844 7,904 0.20 0.12 Runoff Coefficient(C)= 0.51 Runoff Volume V= 0.51 x 7,904 x 9.3 / 12 V= 3,122 ft3 Required Storaqe Volume DV= Postdevelopment Runoff Volume-Predevelopment Runoff Volume DV= 3,122 - 2,641 DV= 481 ft3 Retention MASTER WATER RETENTION 3/16/2018 3s? Comp. By: S/W Date: 3/16/2018 Public Works Department City of Atlantic Beach Permit No: DWAY 18-0008 Address: 805 Plaza Provided Storage: Elevation Area Storage (ft) (ft') (ft) 7.5 234 0 BOTTOM size 18 X 13 8.0 300 134 TOB size 20X15 Elevation Area Storage (ft) (ft') (ft') 0.0 0 0 BOTTOM 0.0 0 0 TOB Elevation Area Storage (ft) (ft) (ft) 0.0 0 0 BOTTOM 0.0 0 0 TOB Inground storage=A"d*pf A=Area= 300.0 d=depth to ESHWT= 4.5 pf=pore factor= 0.3 Inground Storage= 405.0 ft' Required Treatment Volume= 481 ft' Supplied Treatment Volume= 539 ft' Retention MASTER WATER RETENTION 3/16/2018 4 PLAT BOOK 30 PAGES 60-60A OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY FLA. CERTIFIED T0: JAMES AUGUSTINE ui o Q � x LOT 0j n 0 6LOCK ex1 -F- I �0 UTILITIES EASDAENT 2' "2Q"d� E 80~ �'- VL 80.w SEZ� o _^d"IlLfap ff'►/{.LIt7YpYt,} j, La x•------Zy._... 10.2'x,4.2 vi wow _,,� r SHED 7.3' L 0 T 25 1.7' BLOCK �� V✓! � � I � �5.4' S.0't n 3 plo 9�c &/ 111 A� `D i {C P ASC PAD 24.7 `'-tom e4 D N^ 10(116 tie 411 0 47 ss 0 1 � 1a-s ONE STORY tO ' �+ O l 4'? STUCCO a , A P P R®V�® a3 14. oFr�cE AVER PATIp 30 #805 ,v7 ' ...1 b; om d in 0 1 .7' 25'B.R.L.PER PLAT ` Z .T X-•- ti'�f v LN Y WALK cd M N N S7'27*E N 3EARING BASE)95 M 037'27~w 80.6.5. <80' R04T OFw,%-y) APPROVED J PLAT BOOK 30 PAGES 60-60A OF THE CURRENT PUBLIC RECORDS OF DUVAL CoUN7Y, FIA CERTIFIED TO: JAMES AUGUS77NE O 0 �F Y o� �m BLL OTC K1 C ' 00 f J J 10' DRAINAGE do UTILITIES EASEMENT 2' �O'O2irr p� m m G �/.�� SET � o — ri ri 5, NOW mll 10.2'x10.2 WOOD (� 7.3' SHED L O T I .7' LC BOK 5, DENI 4'x4' CONr_ AX PAD } NAll 24.7 (( N^ � + ` M ( I t0 Y � u W 10.5' ONE STORY PIT 0 c1q 0 STUCCO 10. 3 5' RESIDENCE ^Par1C PATI CD A.D. u e d a3 r >� Z �p x c t 24.7' a 8. 25'B.R.L.PER PLAT D' 2 .7' j x adN N C 7'27"E w ERRING BASE)95' t *37*27'W 80.658, PLAZ (80, R+c �a�j �� REVOCABLE ENCROACHMENT AGREEMENT 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 7&-v-s, /1-vq �S},�nG' 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 Atlantico Beach. This work is generally described as t f iC &a cry Any facility maintained, repaired, erected, and/or installed in the exer ise 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 g0-5 P L A 2� IF-,e_ 13 e C- C'G 3 -?:7 • 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 perinit and that all of said liabilities are hereby assume a USER. Date 3 / 3 Property Owner/ a (signed in presence of ry 7 ublic) STATE OF FLORIDA,COUNTY OFD A q The foregoing instrument was acknowledged this day of C 120 0 , who personally appeared before me and (printed name of Signer) +';•�f1* 1 wledged that he/she signed the instrument voluntarily for the purpose expressed in it. Zi ire o otary Public,State of Florida c N � o � Department Approval: NZ ally Known ll 1�6$I ed Identification(Type) F1..- arn0 14' L L✓lSA � 4cottQii%ublic Wor s �irector/ Kayle Moore,Public Utilities Director H:\Master Forms\Public-Utilities Works Forms\Revocable Encroachment Agreement 2.5.18.docx Revision Date:2/5/18 i r(�r:1Pl�lr r RIGHT-OF-WAY/ EASEMENT PERMIT ;ter Permit#Issued by the City of Atlantic Beach PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES Job Address <0"_Q A Z 1 2 Z 3 3 Phone l Q �� 7 �/ Permittee Email V(2-6C)f-nC, ro/"1 Requesting Permission to Construct petv PO r rVe V Location(Reference to Cross-Street)__e f /�Z • 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 Beac or Florida Department of Transportation Standards and be performed under the supervision of to/9'`r�� G V ' 41 (Project Superintendent) with Company Name W fn`,r CC LC- S Phone qc'y 7 q6 7 7 7 7 • 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 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 immediate) on comple Date _ -3 ^�X Permittee(sign n p ence of Notary ub STATE OF F O A,COUNTY OF DUVAL G The foregoing instrument was acknowledged this day of of _120 o , by LL M.1`� f �1ib$'h n ,who personally appeared before me and (printed name of Permittee) acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. Personall Known Signa r 0140-4y' Public,State of Florid -- ntification(Type) i'L JENNIFER JOHNSTON MY COMMISSION 0 GG 042984 EXPIRES:Octobw 21,2020 •a ',�'or i;°• BOtded ThalNota NPubkUm6envriters Building Permit Application Updated 12/8/17 City of Atlantic Beach MAP 1 3 2r?18 800 Seminole Road,Atlantic Beach,FL 32233 Phone:(904)247-5826 Fax:(904)247-5845 ((�� / Job Address: X05 P 1 a s Permit Number: i::)U � V 16 `V Legal Description RE# Valuation of Work(Replacement Cost)$ 'Tc,' Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Al ' Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No 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: 9-01A,t W/ YA'i-er-5 Florida Product Approval# ( for multiple products use product approval form Property Owner Information Name: us hvie Address: 9b5 PIla2-M _ City CL.A C_ State �Zip 322-33 Phone �� (( 7 24 E-Mail i Ctw✓) Owner or-AgeQ0Agent, Power of Attorney or Agency Letter Required) Contractor Information -/ Name of Company: e E V gytCP �r,n/�1��5 Qualifying Agent: 4t J;aI Address Zmv 1120—e--z> 4+ L,.G1City f=ltwri !n4 '_QcI State fiL Zip 32oo3 Office Phone '101.216. 7771 Job Site/Contact Number i 9n`4 .2°6 ??1 1 State Certification/Registration# C RL t32OQL43 E-Mail 69 e,%Wolce a, rr miie5 •cos Architect Name&Phone# Engineer's Name&Phone# Workers Compensation we PILO DDD 322iq Of of Igo i 9 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. 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. 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 RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR A"ATTORNEY E RECORDING YOUR NOTICE OF COMMENCEMENT. (Sign re of caner or Agent) (Signature of Cont inclu contractor) Signed and sworn to(or affirmed)before me this '3 day o Signed and sworn to(or affirmed) before me thisI day of eft JOHN `Cl S els NI yJ\ gnature J d C �..MY COMMISSION#GG 442984 MY COMMISS{ON#GG EXPIRES:October 27, EXPIRES:October 27,2roe ga,r ThruNotaryPublIcUf*rwriters (Si n tureofNotary) ofNotary) ii' ] Personally Known OR [ ]Personally Known OR [Produced Identification [413roduced Identification Type of Identification: F%- ct rk�Ll\S ��L2✓1ST Type of Identification: CJ L 0-t-1 S t