2006 Beach Ave ROW19-0015 directional boring permit RIGHT OF WAY PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ROW19-0015
800 SEMINOLE ROAD ISSUED: 5/22/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 8/20/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA 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:
2006 BEACH AVE RIGHT OF WAY SINGLE OR TWO directional boring $0.00
FAMILY RIGHT OF WAY
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1697020050 NORTH ATLANTIC BCH
UNIT 3
COMPANY: ADDRESS: CITY: STATE: ZIP:
Jacksonville Electric 21 W. Church Street Jackonville FL 32202
Authority
OWNER: ADDRESS: CITY: STATE: ZIP:
HUFFMAN VIRGINIA 2006 BEACH AVE ATLANTIC BEACH FL 32233-5935
MCGUIRE TRUST
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.
PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
Issued Date: 5/22/2019 1 of 2
RIGHT OF WAY PERMIT PERMIT NUMBER
ROW19-0015
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 5/22/2019
ATLANTIC BEACH, FL 32233 EXPIRES: 8/20/2019
2 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
3 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
4 PUBLIC UTILITIES UNDERGROUND WATER SEWER UTILITIES INFORMATIONAL
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 247-5878.
5 PUBLIC UTILITIES UTILITY MAP INFORMATIONAL
Notes:
See attached Utility Map.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
TOTAL:
Issued Date:5/22/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road LJ 00 1
tlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
0;11 E-mail: building-dept@coab.us Date routed:
Cityweb-site: http://vmw.coab.us V
APPLICATION REVIEW AND TRACKING FORM
'I M(.Q Department review required Yes No
Property Address: 0 Building
Applicant: Planning &Zoning
Tree Administrator
Project: &rtc'-�6r%kk bbJ'4j\A -Fublic WPorks
POV-7c M 7ii"e
:s�>
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: R(Approved. [:]Denied. E:]Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed b Date:
�. '�A &_
TREE ADMIN.
Second Review: DApproved as revised. nDenied. []Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. OlDenied. FJNot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
I U'j r
City of Atlantic Beach APPLICATION NUMBER
L'61�11
Building Department (To be assigned by the Building Department.)
800 Seminole Road
?_0 Li co I
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
I it E-mail: building-dept@coab.us L_Daterouted:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
'�COW &Ak�\ )�Zk, Department review required Yes No
Property Address: c
Building
Applicant: -I&A Planning &Zoning
Tree Administrator
Pro'ect:
RUffi—M M i77s:>
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:
APPLICATtCV—N STATUS
000"
Reviewing Department First Review: M<pprovecl. E]Denied. El Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed 0,001 Date:
TREE ADMIN.
Second Review: E]Approved as revAed. [_�Deniecl. E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. E]Denied. F]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
IT
PUBLIC UTILITIES PLAN REVIEW COMMENTS
Date: Application#:
1 —'0 ols
Project Address: 7_00b
Check Box Check
APPLICATION TRACKING COMMENTS to Add Box to
Comme
Underground Avoid damage to underground water and sewer utilities. Verify vertical and
Water Sewer horizontal location of utilities. Hand dig if necessary. If field coordination is
Utilities needed, call 247-5878.
Meter Boxes Ensure all meter boxes, sewer cleanouts and valve covers are set to grade
Sewer Cleanout and visible. 0 11
A sewer cleanout must be installed at the property line. Cleanout must be
RT1 Sewer covered with an RT1 concrete box with metal lid. Cleanout to be set to grade 0 0
Cleanout and visible.
A reduced pressure zone backflow preventer must be installed if irrigation will
RPZ be provided or if there is a private well on the property. Backflow preventer 0 0
Backflow must be tested by a certified tester and a copy of the results sent to Public
Utilities.
Plans note the building will be unsprinkled. if plans change, any fire line
Sensus installed must be metered with a Sensus touch-read meter in a properly sized
Touch-Read vault and an appropriate backflow preventer installed. Backflow preventer 13
Meter must be tested by a certified tester and a copy of the results sent to Public
Utilities.
Fire Sprinkler If fire sprinkler system is provided, call 247-5878 for backflow requirements.
Backflow
Requirement At a minimum, will require a double check backflow preventer.
Fire Line Fire lines must be metered with a Sensus touch-read meter. Meters larger 0 0
Meter than 2" must be installed in a vault as noted in JEA specifications.
Utility Map See attached Utility Map. U(
Disconnect Disconnect and cap water and sewer lines. 0 0
&Cap
Inspection Must call the Inspection Line at 247-5814 to request an inspection of the 0
Prior disconnected and capped water and sewer lines prior to demolition.
0 13
0 13
0 0
0 0
RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION "ALL INFORMATION
City of Atlantic Beach HIGHLIGHTED IN GRAY IS
800 Seminole Road,Atlantic Beach,FL 32233 REQUIRED.
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address 2006 BEACH AV PermitNumber
Contractor Information
CompanyJEA Qualifying Agent
Address 21 WEST CHURCH ST Citv JACKSONVILLE State FL zip 32233
Phone Email
State Certification/Registration#
Architect Phone Email
Engineer JASON CONNER Phone 665-8682 Email CONNJJCa)JEA.COM
Workers Compensation Insurer F7 OR Exem ptl:]Expi ration Date_
• 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 Public Works Director,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 Public Works Director 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 JAMES UMSTATTD (Project Superintendent)
with(Company Name) JEA Phone 665-6125
• All materials and equipment shall be subject to inspection by the Public Works Director.
• 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 30 days. If the beginning date is more than 60
days from date of permit approval then permittee must review the permit with the Public Works Director 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 Public Works Director shall be notified 24 hours prior to starting work and again immediately upon completion.
Date
Permittee(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this day of 20
by who personally appeared before me and
(printed name of Permittee)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
Personally Known
Signature of Notary Public,State of Florida Produced Identification(Type)
H:\Applications&Forms\word Documents\201801001 Right-of-Way Easement Permit Application.dou Revision Date:10/1/18
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