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317 Sargo Rd RESO19-0026 AstroTurf RESIDENTIAL OTHER PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH RES019-0026 800 SEMINOLE ROAD ISSUED: A 'i}9 ATLANTIC BEACH. FL 32233 EXPIRES: MUST CALL INSPECTION • • • 1 / PM FOR • • ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' i 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: RESIDENTIAL OTHER SINGLE OR 317 SARGO RD TWO FAMILY RESIDENTIAL install artificial turn in $3750.00 OTHER backyard TYPE OFBUILDING USE ZONING: :D • • • GROUP: 171702 0000 ROYAL PALMS UNIT 02A3.00 C• ■ ADDRESS: • ADDRESS: Zane Zeman 317 Sargo Rd Atlantic Beach FL 32233 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. Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. i 1 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(904-247 -5814)to request an Erosion and Sediment Control Inspection prior to start of construction. 2 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL Notes: Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapells,Inc., Republic Services,Donovan Dumpsters, Phillips Containers,JDog/Dennis Junk Removal,All American Roll Off,WCA Waste Corporation). Container cannot be placed on City right-of-way. Issued Date: 1 of 2 RESIDENTIAL OTHER PERMIT PERMIT NUMBER s RES019-0026 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: ATLANTIC BEACH. FL 32233 EXPIRES: 3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. 4 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 5 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL Notes: Artificial Turf cannot be installed in utility easement. 6 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL Notes: Water cannot drain to neighbor"s property;must drain to road. 7 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. 8 PUBLIC UTILITIES METER BOX SEWER CLEAN OUT INFORMATIONAL Notes: Ensure all meter boxes,sewer cleanouts and valve covers are set to grade and visible. 9 PUBLIC UTILITIES RTI SEWER CLEANOUT INFORMATIONAL Notes: A sewer cleanout must be installed at the property line. Cleanout must be covered with an RT1 concrete box with metal lid. Cleanout to be set to grade and visible. DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT PU REVIEW BUILDING MOD OR ROW 001-0000-329-1007 0 $25.00 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 WORK WITHOUT PERMIT 455-0000-322-1000 0 $110.00 TOTAL: $160.00 Issued Date: 2 of 2 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assi ned by the Building Department.) yy 800 Seminole Road (Dar fo C Atlantic Beach, Florida 32233-5445 1�GJ 1 Phone(904)247-5826 Fax(904)247-5845 ,E,119' E-mail: building-dept@coab.us Date routed: ! City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3A/G1� ' Department review required Yes No Building Applicant: O (� Q, Planning &Zoning Tree Administrator Project: I nS ��t ( I of _S-{��'�1�t� Pu lic orks u lic i i ies 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: APPLIC_ATION STATUS Reviewing Department First Review: Approved. ❑Denied. []Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: 711�11—Bate: TREE ADMIN. Second Review: A roved as revi d. ❑ 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 PUBLIC UTILITIES PLAN REVIEW COMMENTS Date: Application#: Project Address: Check Box Check APPLICATION TRACKING COMMENTS to Add Box to Commen Print 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. 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 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 ❑ ❑ 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 ❑ ❑ 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 At a minimum,will require a double check backflow preventer. ❑ ❑ Requirement Fire Line Fire lines must be metered with a Sensus touch-read meter. Meters larger ❑ ❑ Meter than 2" must be installed in a vault as noted in JEA specifications. Utility Map See attached Utility Map. ❑ ❑ Disconnect DCap Disconnect and cap water and sewer lines. 13❑ Inspection Must call the Inspection Line at 247-5814 to request an inspection of the ❑ ❑ Prior disconnected and capped water and sewer lines prior to demolition. ❑ ❑ ❑ ❑ 13 0 rji_70 ; ,, City of Atlantic Beach APPLICATION NUMBER �s S� (To be assi ned by the Building Department.) Building Department SEP u 5 2019 800 Seminole Road / !_ Atlantic Beach, Florida 32233-5445 {{�� ,, yt l �KJ Phone(904)247-5826 Fax(904)24P&45--- Q �� ;119'- E-mail: building-dept@coab.us Date routed: 0 City web-site: hftp://www.coab.us —� APPLICATION REVIEW AND TRACKING FORM Property Address: 3 "V 50LtM-D Department review required Yes No Building Applicant: fJ W A k- Planning &Zoning 1 (� Tree Administrator Project: 1115tq I 4L SA l�( i' Pu 5 lic orks 1 I I u b I i c U i i ies (SA,,I,tp`Q� Sib ;T-I ed Public 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. []Denied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed ate: / TREE ADMIN. Second Review: ❑Approved as revised. []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 r - Building Permit Application Updated 10/9/18 City of Atlantic Beach Building Department "ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY �'�i_•I�' Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED. Job Address: 317`�T �� PMA(W�C &v�f,Vj PL 32233 Permit Number: ee5C19 Legal Description Home RE# Valuation of Work(Replacement Cost)$?),750 Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial ❑Residential • If an existing structure, is a fire sprinkler system installed?: ❑Yes ❑No • Will trees be removed in association with proposed roaect? Dyes must submit separate Tree Removal Permit ❑No Describe in detail the type of work to be performed: rAy flfA'IT iC M t0(`� 1-N UC&J j"C) 0.". 57 Florida Product Approval# _ for multiple products use product approval form Property Owner Information Name ZANZ- -LIMA^ Address 3 17 �� city_hc�\P�"c &c-c-\ State Ff zip 32 L � Phone E-Mail ZUVN`rA, M Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company Qualifying Agent Address City Stat „�pg Office Phone Job Site Contact Number AA CLUU1` State Certification/Registration# E-Mail Architect Name&Phone# Engineer's Name& Phone# Building Workers Compensation Insurer OR ExempGityx4 t UaF ea0 illi, 17!L— 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 regulating 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 ATTORNEY BEFORE RECORDI G YO R NOTICE OF COMMENCEMENT. r ignature of Owner or Agent) (Signature of Contractor) Signed and sworn to(or affirmed) before me this QKD day of Signed and sworn to(or affirmed) before me this day of by A JZ Q Mck- by — "P° xJa a N4 042984 42984 (Signature of Notary) rr; MY C A, EXPIRES:October 27,2420 edTtwNotary Public Undervetters Bond [ ]Personally Known OR Personally Known OR ]'Produced Identification (c,, \ [ 1 Produced Identification Type of Identification: Fly &,!h A�(�J Jiy �\,Z t-/1 S1 Type of Identification: ORDERED BY CROCKT.-.TT LAW P.L. REAL ESTATE LAW PROPERTY ADDRESS:317 SARGO ROAD, ATLANTIC BEACH,FLORIDA 32233 SURVEY NUMBER:FLI902.20D2 FIELD WORK DATE: r:/xiQ REVISION DATE(S):mm 2nm0191 19OM2 BOUIMMYSURVEY DUVAL COUNTY LOT e 0 2-Fir NO to N 82°x3'58 jr fir A'L.L.F. LOT IG No to 0 0 D. Awm 0.2-Off 37 O off 2A.7 0.2' P f Lp ul 296 Z O-r 10J ., v; I It N3; ISTY. C1' LOT 15 Q LO 015 BLOCK 25 0 ?_A.7' 0..0" 0.1'Off A' 112'fir "011) 82 Y5W 0. 0 A-G.L-f. W 93.093.00'(P) A Al a Off—I 0 3-5 1(m E7N B.R PLAT) LOT I I JO! 2 ON J SURVEYORS NOTES NOTE-FENCES EXIST;OVAIERSMIF NOT MlIfIRIMMED. PLEASE REVIEW LOCATION ON DRAWING. Lp LOT AFFEAR5 TO Bt SERVICED BY PUBLIC WARM MTD SEWER U2 SETBACK INFORMATION 5NOWN ON PLAT:NOT VEIRVIED. I'z'fir —K NO 111) AVALLA ROAD 932 • 30 0 15 30 N Ym _jdQwj4g my o/sotkgo% /5 a bm wd waift mpnw&**n GRAPI-HC SCALE (In Feet) Vgoft of Pmebbs sM k6 by go Fbda Boad Offth-Ond swwym 5J-17 offt ROW A dWAL**W CC& I inch = 30 ft. Um 01 This SurMlW PurMft oNer Mm Int"eA WfflMd WHUMV"W"'M WM b.MOW URn Sole PJAWWWWWA UMAtY WOW Smv"W NoNhg hereon aAeB Se I:onTbved m Glue ANY 0.pbn ar leneaa m Anyone OuerNan Uveae eMlaed FLOOD INFORMATION: POINTSINTEREST BY PERFORMING A SEARCH WITH THE LOCAL GOVERNING FENCE OVER 5'DRAINAGE AND UTILITY EASEMENT MUNICIPALITY OR WWW.FEMA-GOV,THE PROPERTY APPEARS TO BE LOCATED IN ZONE X(SHADED).THIS PROPERTY WAS FOUND IN THE CITY OF ATLANTIC BEACH,COMMUNITY NUMBER 120075,DATED 11/wIll. • AFFILIATE CLIENT NUMBER:CT-110 2/27119 MEMBERS BUYER.ZANE ZEMAN SELLER:EDWARD AND BARAKAN WHITEHEAD SR CERTIFIED TO:ZANONAL TITE ZEMAN;CR NC LAURANCE W,RL;OLD REPUBLIC NATILE INSCOMPANY Scanned with CarnScanner Pc P-' S = =' F '� 2J This is page 2 of 2 and is not valid without all pages. LC7 10 BLOC-r 75.PEPLAT O^PAvT Cc POYAL PAL-AS U-UT TWO 4.ACCORDING TO THE PLAT THEREOF,AS RECORDED IN PLAT BOOK 31, I t1.0SES G:THE vU?Ll'.Ft_COPOS OF DUVALCOUNTY,FLOP,IDA- I I X?9 SPE_Irr SU?/EYOR NOTES: THE BEA.11i P.EFEPEt10E OF Sera3'59'W 1S BASED ON THE SOUTHERLY PROPERTY UNE OF LOT 10,BLOCK 25,REPLAT OF PART OF ROYAL PALMS UNIT TWO A.AS RECORDED IN PLAT BOOK 31,PAGES 16-160.OF THE PUBLIC RECORDS OF DUVAL COUNTY,FLORIDA. C•E n I E DA L SURVEYOR MOM- •r Ira-'lire•r -wd no ow-4-1kis Ry wa,Sr}pyed by otMn.TMS survey does not determine or imply owrre•ship. 7 It•+.sues M,Ir'Senn,mcrmnem.-r.fmmd Aherne g,ovd Underground footings utilities and encroachment,are not located on this survey map. i P r1...r n A vp✓.UM-r d•Ar-.r+ld sNern mr this.—T.the hcatbn N APMosrnate as the location wasether shown to Exacta Land Surveyors,I.I.C.by a third party or It was mor-anal lot---deer—r->brnrg rod, -4 vkw4bov?gmu•d inspection only.No eaavatbn was performed in order to determine the exact and accurate location. e TM street is rn•1-4 1,vire ice of INP Part•e%to.hener R N certified. 5 Adders„n d.l.rnm•r•h'1 carne map j,'m ont by other than the signing party of parties is prohibited without written consent of the signing party or parties. R rl—"r•r-,A•.rr lr.r rid der imaN the•"f 7 per t•.ra•yme•••�s••uronn mMard,,hnyse dimensions are approximate A a•w+/MA 1p,.y rr.-.dais rn• .—'don,"serve,n for iMormanorut purposes only.Research to obtain such data was performed at www.fema.gor. 0 Arm•n.•im••rMnS.n•r serf mnimum.Wdiameter,l8'ron rebarwdha uP+tamped LBB 8291. In re yowr A•n09"•fin sent m anei.cnem[format the information contained on this document Is only valid If this document Is electronically signed as specified in Chapter 51- 17 fxk>Mere ss+1ln•4a Mmmrsbatw.Coda and fiord.Statute 472 025 The Electronic Signature File related to this document is prominently displayed on the invoice for this survey s.hrh n oro seine•ora••te rmmr Ma—fly,signed and sealed logs of an survey signature tilts arc kept As the office of the performing surveyor.If this document Is In paper format N h am rsld w,thw the sgrrstvre and ciigIMI raised seal of a Florida licensed Surveyor. 11 'em—M,,r—ru,n 4 an-A—einn M the aDstrstt of Title was NOT performed by the signing surveyor to determine which instruments,if any,arc affecting this property. 17 It.'vmb•11•.rl.r ,nM-r,red"g d and on 1hn+urvey may have been enlarged or reduced for clarity.The symbols have been plotted at the center of the field location,and may not •rr r vvm N»Art. rtV 1'slap.or—d the feature 11 amid"1.....Inpl 11 m oke ted aboveground improvements which may be in conflict with boundary,building setback or easement lines,as defined by the parameters of rhn su•nry Thor.may,M addnarol POI's which are not shown,not called out as POI's,or which are otherwise unknown to the surveyor.These POI•s may not represent ail items of rnr.rs+sn the rlrwt 14 1NONW shown on the wbi.,t P,pVersv may or may tilt Nrd"m the e,isieme of recorded or unrecorded utility easements. 15 -tnform i'vyr tonuNs.d on I N%survey has been performed etclufively.And is the sole re}ponsibilitr.of Exacu Land Surveyors,LLC_Additional logo or references to third party fru,sir.for mnf-nese onal purport only. 16 ru•cuanl Ip 1 S 558 0035.an Individual employee of agent may not be held Indfrldualh liable for negligence. 17 shim m.tuam.nt,,hwld not be used for new comtruceien or planning.Measurements should be verified prior to such activity. LEGEND: 5URVEYOR5 LEGEND ® .DA mea e+NeaPrr..�e��r. SUAOAQ IYTD r..mrasee 0 ewe„ATA -. —0s a er i avnsalr taalWYreu1 •'"""r®°.°iota® e [U,DN MAiL sir mTA O �Ol aaroroR suer..—.4 rpa .ru«ertmru maa[Q "rQ'. !/1 [xa.w o..eor� ME! a1P0aYn sr000 rote wpLR =Aoco IM cc0trornc se se LIIRrh«LAMIgt mat Paw11R-_-- Ylnl rprQ � C/apn pin ® Y.6L OlVATUN t0 WMATID Cow r=OFWATER ILT1 Npr10 SCALEle MWS FONT AE ACMEASFMR7 Io DIID DIV Firvic" R-M WDRIN AAEIKNVVERIT'M RAN IACat Of LVIV ANE ANOMMEASdEM P, MD 1M LIECTNCMSta VATIAAOTwA RES. RESIDDRE UAL CANIILMANTEPWACIEWIL AA MfANAED IwCL SMODStR AIMN NAIoNreIQOQTKWE MANGE CUL ONAMMIUMITYEIMT in ALA, EW piMNQ VENnCAL DOW OF aH SIL S1TMd.lais DE ORAVIAQ MSOADIT IR ACOAD M I1 OW uTalw ail MU. o coati(ITISIA SLL SURYEY'4OAAE{at DUE DRAINAGE UTILITY tw 5}."r, fr. R4p11D Ft" ot. oNG141nD ITL SUIVETT[lalE ESM' L45UAW ASAI. A(Ull/w'r yTAAQ VR mol [OQorr•[MDIi o" oFnOALKCO M" Sw, sled Lrrt• Ely? AC AIa comomorOf. IA7N Idlr[IOILLt101E MAV. 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I ,r-i...ante.errs ner.rn urraverdnan a•rle nnp w,uv-uc. 'Gray Scale' ———————-- ———— ..•-� r- VXACTA LAND SURVEYORS LLC. '— .wwavicuyrerc- t v FLG 11:1315 F 966Ica 2687 - -- — - - 11940 Fairway latri 0mr.Su,v 1 Fl AAyers.11 11911 Scanned with CamScanner REVOCABLE ENCROACHMENT AGREEMENT s "ALL INFORMATION City of Atlantic Beach �} HIGHLIGHTED IN GRAY 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 -ZAIIJZQ1yt,A 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 A04--fy –hj{4–' 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 317 SNna Rd, AllltnSG • 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 liabiiilities are hereby assumed by the USER. p / / ! 3; `' - D Date /,ZP/ 9 Propert Ow Agent(signed in presence of Notary Public) STATE OF FLORIDA, COUNTY OF DUVAL The foregoing instrument was acknowledged this day of A Gtt fr% —, 20 by ` Gt1\ '=�Q tv1GLwho personally appeared before me and (printed name of Signer) acknowled that he/she signed the instrumen d in it. i' MY COMMISSION#GG 042984 EXPIRES:October 27,2020 BondedThruNota—PublicUnderw'ters Departm t Approval: Signature of Notary Public,State of Florida [ ] Per onally Known ,f [ roduced Identification (Type) F 10r' J Cl n�4 ,`S L 2/4-� Scott Williams, P Ic Works Director /�•�j H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18 J / artificial turf, manufactured turf, lawn turf, engineered turf, AstroTurf, etc. - we need to test the impervious characteristics of the turf as part of the Public Works Plan Review. If the applicant tells you that artificial turf is part of their plan, please tell them that we request the following: • a 3'x 3' minimum size sample of the turf to be submitted with their plans • detailed plans of the type of sub-base material that the turf is to be installed on • manufacturer Testing Report for the turf COMAV Z114i 9a„ tk -fv Re Cycle(-5 ro� M\/ 4&q0\ on inSAAN' Rf w"Cj wl +-Jf C , 2 fu�� tV4 f-h O"PP(bfr)Ak Svb-fuse ShaUla be 3+ ;ntW5 oP 5 7 (mac ta&5f'i �I PAV.0 FJ" -Pbr o Uj\1'y OOF- 1\1- y q' 6(0111R�e, 5`A[k. L WAS ofii Mclly OAAWAM Phis Q(OQSS fUtvlred c' �-emlt, s k\y`c OmdY rtmo\x- , dtQvJC ,,d + dif} -b oJtrcajNSRk *'\x bf ft ("X,n;ntionn of ?j Mc�►Rs T w i 11 r1,e�d ,f�'tn¢ Svb-(v�s�. 1 hu ro je c+ ;s v s+ ova' 2/000 5C F4 5C, 'T_ 1� �- ►tee !R��Sc C_C)nne"Y Who Q(a�id�� 4'K2 MtOe )A rpcom#vAt Clog M\)cvL _V wod)d -�o Com c��!' 2,xo s� � . VxY Nc a,%m4jd 1 d 13 Yard,, C?� Rc�,r_K yA* of �Qws . r�y -tom Chawnee Gulick From: Zane Zeman <zemanzane@gmail.com> Sent: Thursday, August 29, 2019 5:03 PM To: Chawnee Gulick Subject: Fwd: Artificial grass Zemanzane@Rmail.com 954.464.5368 Begin forwarded message: From: Paul Kaylor<Paul.k@artificialgrassrecyclers.com> Date:August 29, 2019 at 16:59:46 EDT To: "zemanzane@Rmail.com" <zemanzane@Rmail.com> Subject:Artificial grass Hello Zane, We don't have a way to track down a manufacture for the sports fields. We normally just get a contract to come remove the field and ship it from that point. I can tell you all fields have to be commercial grade and designed to endure the use of players constantly on the field. With that being said this will be the most durable turf in the neighborhood with the drain holes it will drain perfectly fine! Please let me know if you have any other questions. Respectfully, Paul Kaylor Regional Sales Representative Artificial Grass Recyclers O: 951-384-6547 C: 951-816-0342 www.artificialgrassrecyclers.com AI` GR ARMICIALGRASS RECYCLERS What is Recycled Turf and why can it be the Right Choice? https://Youtu.be/H1b iOGUazk i Owner Builder Affidavit **ALL INFORMATION HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. r� 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: I. FLORIDA STATUTES;CHAPTER 489, FLORIDA STATUTES, PART 1"CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE.BY LICENSED CONTRACTORS. YOU HAVE APPLIED . FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. II. INJURY LIABILITY;SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. . III. IRS WITHHOLDING;OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES.OWNERS BEING SUBJECT TO$5,000 PENALTY UNDER FLORIDA STATUTE NO.455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY" OR THE FLORIDA"CONTRACTORS CERTIFICATE"TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904- 247-5826 OR BUILDING-DEPT@COAB.US ) IF IN DOUBT. V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. Job Address: '517 fi4cW Rd, Owner Name: UAL 7gnNutn Phone Number: 2154 %4 Ubg Mailing Address: 1 S A!rGIO {Zd City: (3ec.c►n State: Zip: 3223 Notarized Signature of Owner The foregoing instrument was acknowled d before me thisday of 20-A-1in the State of Florida, County of U ft Signature of Notary Public ff,F:-- JENNIFER JOHNSTONMY COMMISSION#GG 042984 ] Personally Known OR [ odu d I entification EXPIRES:October 27,2020 BondedTtw Notary Public UndervrtitersQ n(Type of Identification: FLL ri ( �✓ „ v Updated 10124118 1 NOTICE OF COMMENCEMENT State of let) Tax Folio No. 17 170 2-oocu County of D i 4 f\� To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OFC MMENCEMENT. Legal Description of property being improved: i — 16 17-7- S —Z9E �1n L-aT lC2 12 L X ZS Address of property being improved: 31,7 X10 Q General description of improvements: P\90 Pei OQx u'� �� 1 �( Owner: ?K_7YVIM Address: A±(AA t"L, eWV1' P7(_ 22-77-3 I"► Owner's interest in site of the improvement: NOme Ol,J�1i?S` Fee Simple Titleholder(if other than owner): Name: Contractor: Pl �Apllt 0,5 o,)ae 1 Address: Telephone No.: Fax No: Surety(if any) Address: Amount of Bond$ Telephone No: Fax No: Name and address of any person _making a loan for the construction of the improvements Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may be served: Name: Address: Telephone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b), Florida Statues. (Fill in at Owner's option) Name: Address: Telephone No: Fax No: e Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a differentatsN specified): Z g N g THIS SPACE FOR RECORDER'S USE ONLY OWNER o o$ rr�� 0o � Signed: Date: 51301/ �: z° Doc#2019203415,OR BK 18918 Page 481, Before mex; day of in the County of Duval, t 6:) J. a— Number Pages: 1 U x Recorded 08/30/2019 12:05 PM, Of Florida,hasp sonally appeared '� W g RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Notary Public at Large,State N ida,Count of Duval. m COUNTY My commission expires: ir;p'ds RECORDING $10.00 Personally Known: Produced Identification: 1�J JLV S