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42 3rd St FNCE19-0111 Fence %:o..A. , FENCE WALL OR BARRIER PERMIT PERMIT NUMBER ��� CITY OF ATLANTIC BEACH FNCE19-0111 .)q ISSUED: 12/26/2019 800 SEMINOLE ROAD 'T'�0;:i9'f' _ EXPIRES: 6/23/2020 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: 42 3RD ST FENCE WALL OR BARRIER FENCE FENCE $3000.00 TYPE OF REAL ESTATE ZONING: I BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 170193 0000 ATLANTIC BEACH COMPANY: ADDRESS: CITY: STATE: ZIP: OWNER: ADDRESS: CITY: STATE: ZIP: KENNETH BROWN 42 3RD ST 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. LIST OF CONDITIONS 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 12/26/2019 1 of 2 '-0-4i y. FENCE WALL OR BARRIER PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH FNCE19-0111 ..�:.- fl !:.)vV800 SEMINOLE ROAD ISSUED: 12/26/2019 z JHIO%' ATLANTIC BEACH. FL 32233 EXPIRES: 6/23/2020 4 PUBLIC WORKS FENCING REMOVED INFORMATIONAL Notes: All old fencing and debris must be removed from job site by Contractor. 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: 12/26/2019 2 of 2 rj���7 ,; City of Atlantic Beach APPLICATION NUMBER ( Building Department (To be assigned by the Building Department.) '�` 800 Seminole Road / / I ' Atlantic Beach, Florida 32233-5445 C�- -v 1 Phone(904)247-5826 - Fax(904)247-5845 ^/oj E-mail: building-dept@coab.us Date routed: 9 ist9 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 4 z ,D t 1 Department review required Yes No uildinq_) Applicant: `Pang &Zoni � GO E� ng _ Tree Administrator Project: l— .,L-ie ., ( blic Works CpFus blic ti i leiThltc Safe 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: Vpproved. ❑Denied. ['Not applicable (Circle one.) Comments: No (/�WILDINGWILDING PLANNING &ZONING ,�y� l�I Reviewed by: / i � Date: ' TREE ADMIN. Second Review: A roved as revised. Deni d. ❑ pp ❑ I 1Not 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 ' '�'/-4.. Building Permit Application Updated 10/9/18 J i it ,- r City of Atlantic Beach Building Department **ALL INFORMATION _! 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY -1_6BV-2:!-- IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us r C� Job Address: 4(0 S `P� Permit Number: , N Q,C, i l -U( t Legal Description /(p -" aS — c�9E frii, WACH, Loi (p4. flt lyrryj 4 of8k' . 7 RE# Valuation of Work(Replacement Cost)$ 3�000 Heated/Cooled SFO Non-Heated/Cooled • Class of Work: ❑New ❑Addition Alteration .Repair DMove Memo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial ❑Residential • If an existing structure, is a fire sprinkler system installed?: ❑Yes ❑No • Will tree(s)be removed in association with proposed project?DYes(must submit separate Tree Removal Permit) ❑No Describe in detail the type of work to be performed: _see_ AttfteK6p --bescrf-hd,i Florida Product Approval# for multiple products use product approval form Property Owner Information 1 Name K.f�JNZ.Tt( -BMWP.] Address Eft 3 cc( 5 T121-- City 12 'erCity An A-WIC -BEicireti State vl.- Zip 3D3i Phone 102 6'I v..far. E-Mail iC ci Uf'�pJO Q A UC)• CUM Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company Qualifying Agent IP IR Address City to e Zip Office Phone Job Site Contact Number State Certification/Registration# E-Mail • 3 Zdt9 Architect Name&Phone# AUG Engineer's Name& Phone# Workers Compensation Insurer OR Exempt❑ Expiration Date Application is hereby made to obtain a permit to do the work and installations as indicatedBtatting3tElflartcntqation has commenced prior to the issuance of a permit and that all work will be performed to meet itiv )gt'it t ' .j rr gEil ing construction in this jurisdiction. I understand that a separate permit must be secured for EL CTRICAL 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 RECOR N .f R NOTICE OF COMMENCEMENT. all A— (Signature of Owner or Agent) (Signature of Contractor) Signed and sworn to(or affirmed) before me this 36 day of Signed and sworn to(or affirmed)before me this day of 1.13 t , d 0 tci ,by V 'Q.^ C-P1 (. J-J i1 , by VA AM. 14.' tore d€lYfdl€&ly)IOHNSTUN (Signature of Notary) *: i :-„ MY COMMISSION#GO 042984 E.s.,,^ EXPIRES:October 27,2020 [ ]Personally Known OR [ I Personally °%f4f,?;�' Bonded Thru Notary Public UnderwritersKnown OR [-4-Produced Identification I ,( p [ ]Produced Identification Type of Identification: 11 J f •(All (T It J c1_,Sl.l_4llj^e Type of Identification: • ' L Owner Builder Affidavit **ALL INFORMATION �Sy '`lL'• HIGHLIGHTED IN > ' ;=,'i City of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 x 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 I 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 ISA 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: `la t`4 -TTCE_E.:C Po-I.rwit- &Wig i FL. .3'.D. ?_ Owner Name: KNNet7.1 cnwrJ Phone Number: 7O - 41S- .1&'.5' - Mailing Address: cta <3• STz?ttr City: All iR-A ?1e 8EJ1Kri State: FL Zip: 3.4.1JJJ' Notarized Signature of Owner N. A, l The foregoing instrument was acknowledged before me this 30 day of5 {—, 20 t 7 in the State of Florida, County of tiA.v' 1 Signature of Notary Public P"P'-a;. JENNIFER JOHNSTON i ) Personally Known OR.[/} roduced Identification •: .= MY COMMISSION#GG 042984 =* iuTni '''? EXPIRES:October 27,2020 !ES? Bonded Thru Notary Public Underwriters 1 Type of Identification: L[i � a ¢,�S ( Qn .e._ • Updated 10/24/18 Building Permit Application Job Address: 42 3rd Street Description: Repair fence and existing gates on all 4-sides of property; Remove all 4'pickets; replace rotting or compromised members;attach new 4' pickets with 3 1h "or 4"wide pickets,spaced 21h inches apart,allowing added height differential of 1 to 3 inches (judging terrain) to off-ground all 4'pickets placed along the north,east and west side of existing fence line,as shown on survey; Set four'(4) posts at 3rd Street ROW,two(2) at each driveway entrance;each post size may be up to 8 x 8 by 6 feet tall to support gate opening; Driveway gate to slide parallel to fence; gate height: 4'but tapers to 6'at each post to match post height, with 1 to 3 inches off grade to slide; Remove 5'and 6'pickets,replace rotting or compromised members;attach new 5' pickets and 6'pickets,like-to-like,as shown on survey, Move portion of fence at south and southwest side of property line,and establish western pedestrian gate at Beach Ave.,in areas as shown on survey East side fence repairs are permitted but fence may NOT move east unless and until approval from DEP. riyiyr; _ City of Atlantic Beach APPLICATION NUMBER 0' . •)1 Building Department (To be assigned by the Building Department.) 800 Seminole Road C� ( Atlantic Beach, Florida 32233-5445 —1 - Phone(904)247-5826 Fax(904)247-5845 -J;il�•• E-mail: building-dept@coab.us Date routed: 1 C.� 1.•.� / 19 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 4z__ 3 ( Department review required Yes No '.'Building.--)____ Applicant: O-GO l E2- Planning &Zonin:d) _ Tree Administrator Project: I— LK� _._. (-'Puubblic Works (Publ`Public Uti ides , ic 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. ❑Denied. I Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: - 1-A---/--4----Pate: ?--40' 19 TREE ADMIN. Second Review: Approved as revis d. I '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 BeachAPPLICATION NUMBER ( AiI1 Building Department (To be assigned by the Building Department.) v 800 Seminole Road SEP 0 5 2019 �.1 ' Atlantic Beach, Florida 32233-5445 J CL 1 1 �v < Phone(904)247-5826 Fax(904)247- 5 / J 011 9r E-mail: building-dept@coab.us Date routed: 9 ( t 9 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: - Z- -- -, ( Department review required Yes No guildinq,—) _� Applicant: O .(-'0 ti E2— _ Pianning &Zoning Tree Administrator Project: 1-- x,1`.1 CE c� Work� PublicUfi itl�ies-' `-PUfstrU-safefy3 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. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by w Date: t ! /v JJ -�J� 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. I 'Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 Building Permit Application Job Address: 42 3rd Street Description: Repair fence and existing gates on all 4-sides of property; Remove all 4'pickets; replace rotting or compromised members;attach new 4' pickets with 3 ih "or 4"wide pickets,spaced 2 1h inches apart,allowing added height differential of 1 to 3 inches (judging terrain) to off-ground all 4'pickets placed along the north,east and west side of existing fence line,as shown on survey; Set four'(4) posts at 3rd Street ROW,two(2) at each driveway entrance;each post size may be up to 8 x 8 by 6 feet tall to support gate opening; Driveway gate to slide parallel to fence; gate height: 4'but tapers to 6'at each post to match post height,with 1 to 3 inches off grade to slide; Remove 5'and 6' pickets,replace rotting or compromised members;attach new 5' pickets and 6'pickets,like-to-like,as shown on survey, Move portion of fence at south and southwest side of property line,and establish western pedestrian gate at Beach Ave.,in areas as shown on survey East side fence repairs are permitted but fence may NOT move east unless and until approval from DEP. REVOCABLE ENCROACHMENT AGREEMENT r4 **ALL INFORMATION n1 City of Atlantic Beach • 800 Seminole Road,Atlantic Beach,FL 32233 HIGHLIGHTED IN GRAY \*' Y 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 l6s.1tapTht r vitJ .I ct.d SucCes .S jn, `f11-{? 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. �A)C Ic t 011\ This work is generally described as ]_�tJC� 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 tp USER,said notice to USER shall be given by certified mail, return receipt requested,to the following address ti a J r" $free4 tTLANTlC F•RCf F L • 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 � 3(/ atol Property Owner/Agent (signed in presence of Notary Public) STATE OF FLORIDA, COUNTY OF DUVAL The foregoing instrument was acknowledged this 3t.) day of A,, f, t k , 20 , by 'C- Ak-k-K (a.J f\ ,who personally appeared before me and (printed name of Signer) acknowled ed that he/she signed the instrument voluntaril for t - . .• - - it. `,, JENNIFER JOHNSTON • MY COMMISSION#GG 042984 • rrh EXPIRES:October 27.2020 Department Approval: • ? Bonded Thru Notary Public Underwriters Signature Notary Public,State of Florida [ ] Personally Known _ �� �. oduced Identification (Type) fI, ; tC( (�(,v¢y`� L.Liu Scott Williams, Public Works Director H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18 / //� 1100N " �0 FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION �� Division of Water Resource Management ^" Coastal Constriction Control Line Program 2600 Blair Stone Road,M.S.3522 ffFLOR 'A Tallahassee,FL 32399-2400 Phone:(850)245-7669 WeggigagginSV Permit Number 8040321 DU No.of Pages Attached: 3 FIELD PERMIT PURSUANT TO SECTION 161.053 OR 161.052,FLORIDA STATUTES FINDINGS OF FACT AND CONCLUSION OF LAW: The request for a field permit was considered by the staff designee of the Department of Environmental Protection and found to be in compliance with the requirements of Chapter 62B-33,Florida Administrative Code(F.A.C.). Approval is specifically limited to the activity in the stated location and by the project description,approved plans(if any),attached standard conditions,and any special conditions stated below pursuant to Paragraph 161.053(5),Florida Statutes(F.S.). This permit may be suspended or revoked in accordance with Section 62-4.100,F.A.C. PROJECT LOCATION: #42 3rd Street, Atlantic Beach; Duval County. 360' to 410' south of R-51 PROJECT DESCRIPTION: 1. Installation of a 4' tall open picket fence east of dwelling. 2. Removal of nuisance vegetation, ground vines and palm trees landward of new fence. *** Planting of grass within newly cleared area is authorized. SPECIAL PERMIT CONDITIONS:The permit is valid only after all applicable federal,state,and local permits are obtained and does not authorize contravention of local setback requirements or zoning or building codes. This permit and public notice shall be posted on the site immediately upon issuance and shall remain posted along with local approval until the completion of any activity authorized by this permit.Other special conditions of this permit include: 1. New fence shall not extend further seaward than existing fencing located on properties south of this location. 2. All debris (removed vegetation) shall be removed from the area and disposed of landward of the CCCL 3. Root ball of palm trees shall not be removed. STANDARD PERMIT CONDITIONS: The permittee shall comply with the attached standard field permit conditions. APPLICANT INFORMATION:I hereby certify that I am either:(1a)the owner of the subject property or(lb)I have the owner's consent to secure this permit on the owner's behalf;and that(2)I shall obtain any applicable licenses or permits which may be required by federal,state,county,or municipal law prior to commencement of the authorized work; (3)I acknowl d/ge�atthat 7the authorized work is what I requested;and(4)1 accept responsibility for compliance with all permit conditions. Applicant's Signature . `V'�l/` Date rp)/y/o)Q li Telephone No.(23 (oIs ' tar Applicant's Printed Name 6e%J Z(T/J Address i/d 4,3 ar "fielf ‘`C. If applicant is an agent: / /( ) Printed name of property owner Property owner's address Property owner's telephone no. DEPARTMENT FINAL ACTION AND FILING AND ACKNOWLEDGMENT:This field permit is approved on behalf of the Department of Environmental Protection by the undersigned staff designee,and filed on this date,pursuant to section 120.52,F.S.,with the undersigned designated Deputy Clerk,receipt of which is hereby acknowledged. Trey J. Hatch Zi '7.7",V 7,2 ar ,Trey J. Hatch /11/20/2019 Staff Designee/Deputy Clerk Printed Name of Designee/Deputy Clerk Date EXPIRATION DATE: 05/20/2020 (Emergency permits issued pursuant to Section 62B-33.014,F.A.C.,are valid for no more than ninety days and other field permits are valid for no more than 12 months. The staff designee may specify a shorter time limit.) EMERGENCY PERMIT: FIYES JNO Approved plans are attached: FIVES ❑NO POST PERMIT AND PUBLIC NOTICE CONSPICUOUSLY ON THE SITE PUBLIC NOTICE The foregoing constitutes final agency action.Any person whose substantial interests are affected by any decision made by the Department on the Field Permit has a right to request an administrative hearing in accordance with the provisions of Sections 120.569 and 120.57,F.S. The request for an administrative hearing must comply with the provisions of Rule 28-106.201,F.A.C.,and must be received by the Department(at the address given below)within twenty-one(21)days from the date of this notice. When the Department receives an adequate and timely filed request for hearing,the Department will request the assignment of an administrative law judge.Once the administrative law judge is requested,the Division of Administrative Hearings will have jurisdiction over the formal proceeding and the Department(as the referring agency)will take no further action with respect to the proceeding except as a party litigant. Section 120.54(5)(b)4,F.S.,and Rule 28-106.201(2),F.A.C.,explain that the following items must be included in a petition for a formal administrative hearing (a) The name and address of each agency affected and each agency's file or identification number,if known; (b) The name, address,any e-mail address, any facsimile number,and telephone number of the petitioner, if the petitioner is not represented by an attorney or a qualified representative; the name, address, and telephone number of the petitioner's representative,if any,which shall be the address for service purposes during the course of the proceedings;and an explanation of how the petitioner's substantial interests will be affected by the agency determination; (c) A statement of when and how the petitioner received notice of the agency decision; (d) A statement of all issues of material fact disputed by the petitioner,or a statement that there are no disputed facts; (e) A concise statement of the ultimate facts alleged,including a statement of the specific facts that the petitioner contends warrant reversal or modification of the Department's action; (f) A statement of the specific rules or statutes the petitioner contends require reversal or modification of the Department's action, including an explanation of how the alleged facts relate to the specific rules or statutes;and (g) A statement of the relief sought by the petitioner,stating precisely the action that the petitioner wants the Department to take with respect to its action. A person may request an extension of time to petition for an administrative hearing.The person filing the request for extension must do so within the time limits for filing a petition described above.The request must state why an extension of time is needed. The Department will grant an extension only when good cause is shown. If a petition or a request for time extension is filed,further order of the Department becomes necessary to effectuate this Field Permit.Accordingly, the Department's final action may be different from the position taken in this notice.Actions undertaken by any person under this permit,pending the lapse of time allowed for the filing of such a request for hearing,may be subject to modification,removal,or restoration. Failure to petition within the allowed time frame constitutes waiver of any right that a person has to request a hearing under Section 120.57,F.S., and to participate as a party to the proceeding.If a legally sufficient petition for hearing is not timely received,this notice constitutes final agency action. When this order becomes final and is filed with the Department Clerk,any party to the order has the right to seek judicial review under Section 120.57,F.S.,and Rule 9.030(b)1(c)and 9.110,Florida Rules of Appellate Procedure. A notice of appeal must be filed within thirty(30) days with both the Department Clerk(see address below)and with the appropriate district court of appeal.The notice filed with the district court must be accompanied by the filing fee specified in Section 35.33(3),F.S. Any subsequent intervention will be only by the approval of the presiding officer on motion filed under Rules 28-5.207 or 60Q-2.010,F.A.C. All requests for hearings are to be filed with the Department at the following address: Florida Department of Environmental Protection Office of General Counsel Department Clerk 3900 Commonwealth Boulevard Mail Station 35 Tallahassee,Florida 32399-3000 8040321 DU Permit Number STANDARD FIELD PERMIT CONDITIONS The following conditions shall apply to FIELD PERMITS(unless waived by DEP or modified by special permit condition). In the event of a conflict between a field permit condition and a special permit condition,the special condition shall prevail. 1) The permittee shall carry out the construction or activity for which the permit was granted in accordance with the plans and specifications that were approved by DEP as part of the permit.Any deviation there from shall be grounds for suspension of the work and revocation of the permit pursuant to Section 120.60(7),F.S.,and may result in assessment of civil fines or issuance of an order to alter or remove the unauthorized structure,or both.No other construction or activities shall be conducted.No modifications to project size,location,or structural design are authorized.A copy of the permit shall be conspicuously displayed at the project site. 2) The permittee shall conduct the construction or activity authorized under the permit using extreme care to prevent any adverse impacts to the beach and dune system,marine turtles and their nests and habitats,or adjacent property and structures. 3) The permittee shall allow any duly authorized member of the staff to enter upon the premises associated with the project authorized by the permit for the purpose of ascertaining compliance with the terms of the permit and with the rules of DEP,until all construction or activities authorized or required in the permit have been completed and the project accepted by DEP. 4) The permittee shall hold and save the State of Florida,DEP,its officers and employees,harmless from any damage(no matter how occasioned and no matter what the amount)to persons or property that might result from the construction or activity authorized under the permit and from any and all claims and judgments resulting from such damage. 5) The permittee shall allow DEP to use all submitted records,notes,monitoring data,and other information relating to construction or any activity under the permit for any purpose it may deem necessary or convenient,except where such use is otherwise specifically forbidden by law. 6) Construction traffic shall not operate and building materials shall not be stored on vegetated areas seaward of the control line,unless specifically authorized by the permit.If(in the opinion of DEP staff)this requirement is not being met,positive control measures shall be provided by the permittee at the direction of DEP staff.Such measures may include temporary fencing,designated access roads, adjustment of construction sequence,or other requirements. 7) The permittee shall not disturb existing beach and dune topography and vegetation except as expressly authorized in the permit. Before the project is considered complete,any disturbed topography or vegetation shall be restored(as prescribed in the permit)with suitable fill material or revegetated with appropriate beach and dune vegetation. 8) The fill material shall be obtained from a source landward of the control line and shall consist of sand which is similar to that already on the site in both grain size and coloration.This fill material shall be free of construction debris,rocks,or other foreign matter.A sample of the sand shall be provided to the staff representative of the Bureau of Beaches and Coastal Systems during the preconstruction conference. 9) If surplus sand fill results from any approved excavation seaward of the CCCL,such material shall be distributed seaward of the CCCL on the site,as directed by DEP staff(unless otherwise specifically authorized by the permit). 10) Any native salt-resistant vegetation destroyed during construction shall be replaced with plants of the same species or,by authorization of DEP,with other native salt-resistant vegetation suitable for beach and dune stabilization.Unless otherwise specifically authorized by the staff,all plants installed in beach and coastal areas(whether to replace vegetation displaced,damaged, or destroyed during construction or otherwise)shall be of species indigenous to Florida beaches and dunes(i.e.,sea oats,sea grape, saw palmetto,panic grass,salt meadow hay cord grass,seashore salt grass,and railroad vine). 11) All topographic restoration and revegetation work is subject to approval and acceptance by DEP staff. 12) If not specifically authorized elsewhere in this permit,no operation,transportation,or storage of equipment or materials is authorized seaward of the dune crest or rigid coastal structure during the marine turtle-nesting season.The marine turtle-nesting season is May 1 through October 31 in all counties(except Brevard,Indian River,St.Lucie,Martin,Palm Beach and Broward counties where marine turtle nesting occurs during the period of March 1 through October 31). 13) If not specifically authorized elsewhere in this permit,no temporary lighting of the construction area is authorized at any time during the marine turtle-nesting season and no additional permanent exterior lighting is authorized. 14) This permit has been issued to a specified property owner and is not valid for any other person. 8040321 DU Permit Number: DU'form 73-122(Updated 5/05) ''' `� } a� 600c "' ;i dpoi 446 t> f meq„ 41 40', 4 - +.. _.. `�_ -�.. iecr M•i irS _ • L*--.',! , .r €a u . 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