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522 Aquatic Dr FNCE19-0132 6' t�"'sJ` FENCE WALL OR BARRIER PERMIT PERMIT NUMBER '• 1 , /�� FNCE19-0132 14,x- v) CITY OF ATLANTIC BEACH \ 800 SEMINOLE ROAD ISSUED: 11/7/2019 ,,�0.i1�9;- EXPIRES: 5/5/2020 ATLANTIC BEACH. FL 32233 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: 522 AQUATIC DR FENCE WALL OR BARRIER FENCE 6' FENCE $1800.00 TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 171818 5174 AQUATIC GARDENS COMPANY: ADDRESS: CITY: STATE: ZIP: OWNER: ADDRESS: CITY: STATE: ZIP: BURCHELL REBECCA 522 AQUATIC DR 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. 4. Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 1 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during 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. 3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. Issued Date: 11/7/2019 1 of 2 t 'n,..„ FENCE WALL OR BARRIER PERMIT PERMIT NUMBER ,' `� FNCE19-0132 r;,: , ., �, CITY OF ATLANTIC BEACH \'� ISSUED: 11/7/2019 800 SEMINOLE ROAD 4o;ti2% V ATLANTIC BEACH. FL 32233 EXPIRES: 5/5/2020 4 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 5 PUBLIC WORKS FENCING REMOVED INFORMATIONAL Notes: All old fencing and debris must be removed from job site by Contractor. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PLAN CHECK 455-0000-322-1001 0 $17.50 FENCE 455-0000-322-1000 0 $35.00 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $81.50 Issued Date: 11/7/2019 2 of 2 oldu ri, City of Atlantic Beach APPLICATION NUMBER rt Building Department (To be assigned by the Building Department.) 800 Seminole Road F"- , J 3 7.5...4=0-.. Atlantic Beach, Florida 32233-5445 , '�J a t( D 1 z. h, Phone(904)247-5826 • Fax(904)247-5845 ;;t 7 E-mail: building-dept@coab.us Date routed: I Z9 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z tos oPT[ cz_, D, Department review required Yesz'No `C Lildi,• Applicant: CwG� Mann iti &Zonin Tree Administrator Project: V FE PublicC Utilities 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: gcoproved. Denied. I 'Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: /[ - Date:JO -V-)°/9' 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. I 'Denied. Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 BuildingPermit Application OFFICE COPY U oted10918 pp � �� l City of Atlantic Beach Building Department **ALL INFORMATION �'' y,�. 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY Lu&)` IS REQUIRED. Phone: (904) 247-5826 Email: Building ueptL)coab.us / \ z 3 Job Address: r,),A I1 �1�o -h c 0`I VL 5 `'-53 Permit Number:: ►� 1\)C-e- 19 -V 1 a- Legal Description 3s6 -1t— 11 9,5 - 9,°I 6 Ri I 'h C Cy(c enc L t l t'AEU 1 710191517* Valuation of Work(Replacement Cost)$ ICCIOo 1 ab Heated/Cooled SF Non-Heated/Cooled • Class of Work: !New DAddition DAlteration DRepair OMove ODemo OPool OWindow/Door • Use of existing/proposed structure(s): ❑Commercial IEKesidential • If an existing structure, is a fire sprinkler system installed?: DYes I9�lo • Will tree(s)be removed in association with proposed project? DYes(must submit separate Tree Removal Permit) Ello Describe in detail the type of work to be performed: TfleACW / ctot 1,14 h I �t - V1 r-1 t -(- ft nw Florida Product Approval# for multiple products use product approval form PropeOwner Information - Name P.b(C&.lL, 6 (one tit, Address x`12- Seven i- t. f City l`c' .L vitt tv.. (?,ILLCkr, State 1=L Zip 3).oS,9• Phone Ci Ut 501 OS 04 E-Mail p3 k) CL hl,ILL- C Y r C 010.0 I , e. Opel Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) Contractor Information RECEIVED Name of Company Qualifying Agent Address City State Zip Office Phone Job Site Contact Number State Certification/Registration# E-Mail OCT 2 8 2019 Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Insurer OR Exempt❑ ExpiratioMdr Application is hereby made to obtain a permit to do the work and installations as indicated. I certity wf l� tion as commenced prior to the issuance of a permit and that all work will be performed to meet the standards Of 11 ffie alw.4egui...i cla� I F�- construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS, kl 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 0 there may be additional permits required from other governmental entities such as water management districts,state agencies,or h federal agencies. LT t3 MI' OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance wittallan t applicable laws regulating construction and zoning. 'L= x .. Z WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MASS`-.4 o RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTptJD Lai a o a TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE w U a \\G RECORDING YOUR NOTICE OF COMMENCEMENT. p Z o a (Signature of Owner or Agent) (Signature of Contractor) CC B H Z W Signed and sworn to(or affirmed)before me this LI_ g �� day of Signed and sworn to(or affirmed)before me this deo� a uJ m lr, •�J�.�' ,, 1 by 1<�. - �,' ✓ U- ,by 1,11 -OC O n!i qi,nPkty, 1 V W W LU '.(Sigq.` .oMutant) (Signature of Notary) — CC w 'syr .issn * qr Li W 5 .1y Gumi ',.pues i�l' LC CC [ )Personally Known ORti'f 0 °? ""dal m:, [ ]Personally Known OR 'roduced Identification r I ]Produced Identification ifype of Identification: ---- _,1 A _ Type of Identification: 1 MAP SHOWING BOUNDARY SURVEY OF 10T 10-A ACCORDING TO THE PLAT OF AQUATIC GARDENS AS RECORDED IN PLAT BOOK 38 , PAGE(S) 71 AND 71A OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. CERTIFIED TO: ARLENE BALDWIN. N 0T1602" F 50.09' (I1 t/2• FIRST AMERICAN TITLE INSURANCE COMPANY, N OTI5lTI-W 50.05'(M) CORP WATSON b OSBORNF, TITLE SERVICES, INC. 0.3' v2.cAp 0.3.,./ + 1704 a z4' 1-11 -r K- -■l---■--- AND AEGIS WHOLESALE CORPORATION. +uNREAOABLE t cu. . a -1. -1---=4--- Suatrr34oN AOU RP( - .-- � —- To t. p 0.3' Q3Y'''0 O I.P.1TD CJJ. LOT 10-A coVa 3• Q ' PAIN) c7:2_, v . a srafs p EC3-' :\1 [..,21E NAL SCRi3i0.4',,,sI p 20.0 SHED 0-: PORCH. N• -A/c 1AS' "PAD PAD LOT 10-8 12.0' 0.1' it o LOT 9-0 4 1 I-.. 1 1 2 STORY 1 k 2 SURLY ! N FRAME k COQUINA FRAME t CDg11R1A hie RESIDENCE c wn2-_1�a s WM2'-IR-EAVES -� wIn NOS22 NO ik *3 ooVo. k - 3.e' u.R' 15.0' -_-• 1 • g CIO •A. co n o • M PI - _0.5• o gi 20.�' a o 4 ti s.6'.• - . 4i ITT •- el a` �h �- -- - - w3EnoABLE :• ' \ til. tl .. ai V. \ . ,: '.PO - PRivATE ORa:::ILEIOAY i., - PL- EASEMdIT 0 \ .- - .S'.. •, Ire CP- 13 ``• •� ✓ P.LS 71e, _ r__ 1576 m 1___ —4,-- — 1LOT 11-A ) 1 15' FASEIIEVF UITUTES &SEWERSl as w°uvr LAVE —. \ MIR DRAINAGE aV E Y0R • { 1�T(+' 6J 4�,.%;s 1.BEAMS ARE BARD 01 *>�T OQQ1 Y;PAGE 7IA Z STRUCTURE NO._ 9117111 HEREIN UES M11N1 0.000 I'ONE IT AS REST O ASSOCIATED SURVEYORS INC. 3.THIS IS A Aa 9UEREY PAWL OF Imo fool , W LAND t ENGINEERING SURVEYS PIPES AND UEUOE1ERYINEO• �s�ii � ilq W ANY,NOT r - :: A.JUPo971C110NAL trove FIMRQNNmTALLY SEN9 , 3646 BLAMING RTOULEYARD tOGIIEO 67 DID SLRIET. 5 If ANY, Nor SONMUE, FLORIOA 32210SURVEY BONS SHED. THE Ft1BUc -/• •% 't 1704-771-6A66 5 RECORDS NEREOIT SEARCHED BYINS SURVEYOR FOR EASEMENTS, D g -s Y CfA17FICit1F`A,RHORI7ARON N0. LB 0005A6e TITLE.CDIFNANtS RESTRICTIONS.CLOSURES, TAKINGS OR ORDWANCES LTC. THERE COULD BE OTHER MATTERS OF RECORD THAT AFFECT 0415 PARCEL I HEREBY CERTIFY THIS SIJINL-Y WAS DONE UNDER 1111 I.UNLESS OTHERWISE STATED ALL IRON PIPES FOUND HAVE NO bCN1ETU1RpV OIRECT SUPERMSIG1r AND MEETS ',HE LILVIMUM TECHNICAL LSODD/k�11EY,AT10N. STANOARDS FOR N0 '1!VEYING NS.I.ANT TO CHAPTER 0 ' W P sET '4 PIPE C41 PERMP.C.".PONT OF CURVE CON'!)-OQN[11O 61C 17- FLORIDA ADM RATION COD---. A 72. r.5. 11 ASSOC.SURYLY OR L8.546e P T. ..PONT of 1M 3 [l A.ELECTRIC Eat MONO IRON RN OR POPE OP P.R.C. -PONRtT Or E CLEW r7 ■ F(1J C01CIE7E Lumen (ay.) P.C.C. -PONT OF WOOt11O CLAM HY: , r - / 'c''----' It CROS CUT OR ORTu. INTI£ C(l -CENTER ONE RCN KIWI OF NAY C • B. FI ITCHE71 flORb11 CVO l UTE NO.3771 (R RECORO (Y) - NEA�nLEU OOHC CONCRETE ELT-RIJI.p1K Ix CHARLES L STARLING • FLORIDA CER MATE NO.4579 O.RA..0MCIAL RECORD BOOK A`C-WATER RR R (E7,j - EJIVE TIE RAYMOND J. SCHAEFER FLORIDA CERTIFICATE NO. 6132 O.R.V.-omCAL Rtm°Waw( F.((O. -POOL IOUWIDR H3.- our rar -.-GlY ARQ HM - P.R.Y.-PE1•R10/T Hipp°W MUTT -O.U.--OVER LEAD uumis CI1 -Dow JO8 NO. 39219 DATE 12-29-2003 B.R.L.-(WILDING RESTRICTION UNE. IT-II 01NN 111(F1:gCF NTLI -BETWEEN SCALE: 1 2D' DRAFTER W, POd Ctl ET -DLL,RIC HUALOORMER 1 PAD W-+Y MRL' FENCE 0-U BOOD FENCE - s_1(10 J.EA +JIO®TAlf[1.tC11CC NJ1f01BTr C k R -- COVENANTS t REWC°13 NS NOT VALID WITHOUT THE SIGNATURE AND THE SEAL or A FLORIDA LICENSED SURVEYOR AND MAPPER irLy City of Atlantic Beach APPLICATION NUMBER tiS�� 6 Building Department (To be assigned by the Building Department.) I . - ., 800 Seminole Road Fia)eC iq r D i 3 Z. - �. Atlantic Beach, Florida 32233-5445 (-' I i Phone(904)247-5826 • Fax(904)247-5845 \ uit �%• E-mail: building-dept@coab.us Date routed: I C, Z9 19 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Z Z Property Address: 5 AQl1PiT l C:-. L (Fa._ Department review required Yes No `TI uildina Applicant: (/VE -L in &Zonin [� Tree Administrator Project: 6 FGl) �C k., Public Work'-` --) Cl Public Utilit -- 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: pproved. ❑Denied. ❑Not applicable (Circle one.) Comments: BUILDING j PLANNING &ZONING Reviewed by: ��% `moi Date: I 1' I - I TREE ADMIN. Second Review: Approved as revised. Denied. pp ❑ 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 t1:°i,(0y� City of Atlantic Beach APPLICATION NUMBER • Building Department (To be assigned by the Building Department.) i 800 Seminole Road (, =, Atlantic Beach, Florida 32233-5445 UC Z p F 11 ( - 1 -b1 Z Phone(904)247-5826 • Fax(904)247-5845 J 4• �� /�� <'!.`o;t >� Email building-dept@coab.us Date routed: I r /17--7 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: L I Qvp.,Z t C ID iL. Department review required Yes No Ctuilding_.2_ Applicant: )wf ::3 Ct'� ,_Plar:ing &Zonm , _ Tree Administrator Project: 6.: _: , EE- e_E _Public Works Public Utilities 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: I 'Approved. LXienied. I INot applicable (Circle one.) Comments: BUILDING PLANNING &ZONING c. Reviewed Date: ' TREE ADMIN. Second Review: pproved as revised. ❑Denied. ['Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES 7 PUBLIC SAFETYReviewed by: i /,� b-te: --- r I/eLr /vi5r4s , FIRE SERVICES Third Review: I 'Approved as revised. I 'Denied. Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 PUBLIC WORKS PLAN REVIEW COMMENTS Date: /0�gfj/f Application#: i�C�/y "' 4'f.Z.. Project Address: j' 2 24,14/6CA CORRECTION ITEMS Check Box to Select CSMP 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. DPLN Provide drainage plans showing site topography (flow arrows, etc.). ❑ ESCP Provide erosion and sediment control plans with installation details. 0 IMPS Provide impervious surface calculations for entire lot(existing and post construction). 0 Section 24-66(b) of the Land Development Regulations requires on-site storage for increased run-off LDCS if adding 250 SF or more impervious surface. Provide Delta volume calculations and on-site retention 0 required per Section 24-66(b). —/ REPM A Revocable Encroachment Agreement must be submitted. 4! RMRO All runoff must remain on-site. Cannot raise lot elevation. 0 RWPM A Right-of-Way Permit must be obtained. 0 TSUR Provide a pre-construction topographic survey prepared by a Florida Licensed Professional Land ❑ Surveyor, showing 1' contours. CUT Provide manufacturer cut sheets for 50%credit on Turf Block pavers. 0 DW Maximum driveway width within the City right-of-way is 20' (circular driveway width is 12' maximum). 0 PAV Provide paver installation method (must meet I.C.P.I.). 0 WRA Provide a detailed plan of water retention area and how water runoff gets to water retention ❑ areas and then to street. WR Provide detailed plans showing proposed water retention. 0 SID Concrete sidewalk must continue through driveway. 0 50 Documentation shows impervious areas are over the 45%allowed by City code. 0 0 Revised 2/26/19 cPPUBLIC WORKS PLAN REVIEW COMMENTS Date: /[/ /"�` / Application#: A(1G)--' /9- 6/ 3 �-- Project Address: '2" 9-7Ct>`G V CONDITIONS OF APPROVAL TO PRINT ON PERMIT Check Box to Select All concrete driveway aprons must be 5"thick,4000 psi, with fibermesh from edge of pavement Driveway to the property line. Reinforcing rods or mesh are not,allowed in the right-of-way. ❑ Apron (Commercial driveways—6" thick). Full erosion control measures must be installed and approved prior to beginning any earth Erosion Control disturbing activities. Contact the Inspection Line (247-5814)to request an Erosion and Sediment 0 Control Inspection prior to start of construction. Onsite All runoff must remain on-site during construction. Runoff Post Const. If on-site storage is required, a post construction topographic survey documenting proper TOPO construction will be required. All water runoff must go to retention area and retention overflow 0 Survey must run to street. Pool Pool—Wellpoint (if used) must discharge into vegetated area 10' minimum from street or drainage 0 Wellpoint feature (swale, structure or lagoon). Roll off container company must be on City approved list(Advanced Disposal, Realco Recycling, Roll off Shapells, Inc., Republic Services, Donovan Dumpsters, Phillips Containers,JDog/Dennis Junk Container Removal,All American Roll Off,WCA Waste Corporation). Container cannot be placed on City ROW. ROW Restoration Full right-of-way restoration, including sod, is required. �+ Utility Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid 0 Road Cut 10' in each direction from the center of the cut. Repair must be shown on the plans. Construction Provide construction site management plan, including location of silt fence, dumpster, portable ❑ Site Mgmt. toilet. Right-of-Way Permit is required if using right-of-way for construction parking. Runoff All runoff must remain on-site. Cannot raise lot elevation. Document Strongly suggest thorough documentation of impervious areas be recorded. 0 Impervious Slab Slab and driveway to be fully removed. 0 Driveway Maximum Maximum driveway width within the City right-of-way is 20'. 0 Driveway Circular Maximum circular driveway width within the City right-of-way is 12'. 0 Driveway Grass Full site to be grassed. ❑ TOPO Must provide a topographic (TOPO) survey with water retention for final CO Inspection. ❑ Survey Revision Any plan change must be submitted as a Revision to the Building Department. 0 Fencing All old fencing and debris must be removed from job site by Contractor. Removed Decking All old decking and debris must be removed from job site by Contractor. 0 Removed Infra- Any damage done to infrastructure must be repaired by Contractor. 0 structure Revised 2/26/19 Revision Request/Correction to Comments *`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"—QC € l ( '"45-‘l& Revision to Issued Permit OR Corrections to Comments Date: l l 1 ( A I i Project Address: iN. Ton-4-i_ _ Contractor/Contact Name: Cil 11€c- Contact 1C c-Contact Phone: Email: • Description of Proposed Revision/Corrections: KeNioe_ 6:21-,_)I --i _ L----iNC1_1` Oc"-\._ ilr\ iCT I affirm the revision/correction to comments is inclusive of the proposed changes. (printed name) • Will proposed revision/corrections add additional square footage to original submittal? CI No ❑ Yes (additional s.f.to be added: ) • Will proposed revision/corrections add additional increase in building value to original submittal? ❑No ❑*Yes (additional increase in building value: $ ) (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 ,� i/,%! _ iipp-ir-dp- , ._ _ Planning&Zoning T � Tt r +_ Reviewed By Tree Administrator '� _: `, Tis Utor is NOV p 4 2019 /i</7 /Public Utilities / Public Safety 1 i LI Date 000 Fire Services "r' — -------__-__ Updated 10/17/18 REVOCABLE ENCROACHMENT AGREEMENT City of Atlantic Beach **ALL INFORMATION 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 C ti.Lc. EA ].] ,L11 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 (o 1U Cl 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 b, certified mail,return receipt requested,to the following address J ),�, n CI cL�]C�. v((V V A-1-6.ntic.: {ct C� pt. .33a33 • 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 liabilities are hereby assumed by the USER. Date ( . . I c't Property Owner/Agent (signed in presence of Notary Public) STATE OF FLORIDA, COUNTY OF tIttre The foregoing instrument was acknowledged this day of /i)v?-"hl h'..c , 20 /l , by /t'z,h L'-C'.C'C& J L/ri-Me./I , who personally appeared before me and (printed name of Signer) acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. ussti Department Approwl: I{ut ALN saJI0x3'wwo3,(w v,o, /Signature of Notary Public, State of FI ridatestt DDx uoissiwwo) e ( ] Personally Known �pt�oh io alelS•)11a%,AteloN , 403T)w S303) 3W or/ (0-Produced Identification(Type) ! Scott Williams, Public •r s Director H:\Applications&Forms\Word Documents\20180831 Revocable Encroachment A8reement.docx Rev+s4on Dale.8/31/18 ��/�� .-twvii, City of Atlantic Beach APPLICATION NUMBER ,-' O- .:::•:, Building Department (To be assigned by the Building Department.) ':Iv 800 Seminole Road Fiv c... I q 0 13 � Atlantic Beach, Florida 32F233(-950444)52 1 ' l t -5,7. .:L. Phone(904)247-5826 . ax 47-5845 ( v �� -111 5 E-mail: building-dept@coab.us Date routed: 19 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 5 Z z i Q -rt fa Department review required Yes ' No Cl3uildin9_.) Applicant: (/v jv E2_ —.Raining &Zonin Tree Administrator Project: r FG.I CE < Public Works Public Utilitie`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: ❑Approved. ❑Denied. of applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: ate:42—Z?—/? TREE ADMIN. Second Review: ❑Approved as revis . ❑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 Permit Inspections City of Atlantic Beach Permit Number: FNCE19-0132 Description:6' FENCE Applied: 10/29/2019 Approved: 11/5/2019 Site Address: 522 AQUATIC DR Issued: 11/7/2019 Finaled: 11/13/2019 City,State Zip Code:Atlantic Beach, Fl 32233 Status: FINALED Applicant:<NONE> Parent Permit: Owner: BURCHELL REBECCA Parent Project: Contractor:<NONE> Details: OWNER BUILDER LIST OF INSPECTIONS SEQ SCHEDULED DATE COMPLETED DATE TYPE INSPECTOR RESULT REMARKS ID 11/13/2019 11/13/2019 CC ZONING Brian Broedell PASSED Notes: Rebecca:501-0504 11/13/2019 11/13/2019 CC BUILDING Brian Broedell PASSED Notes: Printed: Monday, 25 November, 2019 1 of 1 •