331 7TH sT 2014 DRIVEWAY (2)CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND
800 Seminole Road
Atlantic Beach, Florida 32233-5445
PLEASE SUBMkI,�*COM/PLETE SETS OF PLANS WITH APPLICATION.
Date %/ / TA
� 7
JobAddress 33f ? iCrF.� Si 3rrACH F� 32z3fPEIRMIT#
ISSUED RY THE CITY
Permitee: TortN �Slo�acT
Telephone #
Permittee Address: '3 3 / 77-'4 s i ,4Tz-At4-^LL-_ aC,-ac�,( mac. a
JUL 2 8 2014
�AITL+
7-5800
Requesting Permission to Construct: 72-cP444ac �'x25T�vy �2zv i*y wynl &,o C, NA�N
[fit;' "�6Rvxbug .� 1'r.,,p62y��,S PA✓E2S
Location: (Reference to Cross -Street) �-r M STl1-E E�Sr cmc sem' 72 A654--/1
Applicant declares that prior to filing this application he has ascertainedthe location of all existing utilities,
both aerial and underground and the accurate locations are shown on the sketches.
A Letter of Notification was mailed to the following Utilities/Municipalities:
Jacksonville Electric Authority Yes ( ) No ( ) Date:
Bell South Telephone Company Yes ( ) No ( ) Date:
Ferrell Gas Yes ( ) No ( ) Date:
Comcast Yes ( ) No ( ) Date:
2. 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 of 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.
3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be
performed under the supervision of * . 5,674 `-' CoL4ZA)S (Cont actor's fiir7 's Project
Superintendent) located at 331 7-r" Sr 47-zo.srre ,36�H� 3 e#: 4
F:2z33 Telephon1 J -
4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee.
5. 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.
6. 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 anv increase in impervious :rea on owner's lot or in the city
Right of Way are to be included with this application.
7. This permittee shall commence actual construction in good faith with 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.
8. 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.
9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again
immediately upon completion.
OWNF)
Signed: Date: 7 :i�ll Y
Before me this / - day of in the County of Duval,
State Of Florida, has personally appearedSv N N c, S req c7 �' My 00140M tFF 051075
Notary Public at Large, State of Florida, County of Duval. * « EXPIRES: SOM W 15, 2017
My commission expires: S� r . es Z-17 X Personally Knotl4 , M BMYd1liryAwprtlVarryllMtlal
Produced Identification: