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724 Selva Lakes Cir DWAY20-0006 Paver DRIVEWAY PERMIT PERMIT NUMBER ��. CITY OF ATLANTIC BEACH DWAY20-0006 �" - ISSUED: 2/13/2020 800 SEMINOLE ROAD s � ATLANTIC BEACH. FL 32233 EXPIRES: 8/11/2020 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: 724 SELVA LAKES CIR DRIVEWAY SINGLE OR TWO PAVER DRIVEWAY $2450.00 FAMILY DRIVEWAY TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 172027 5844 SELVA LAKES UNIT 03 COMPANY: ADDRESS: CITY: STATE: ZIP: OWNER: ADDRESS: CITY: STATE: ZIP: MCCULLOUGH MAUREEN 724 SELVA LAKES CIR ATLANTIC BEACH FL 32233-4368 A 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 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 ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. Issued Date:2/13/2020 1 of 2 DRIVEWAY PERMIT PERMIT NUMBER ' DWAY20-0006 .¢` CITY OF ATLANTIC BEACH ISSUED: 2/13/2020 800 SEMINOLE ROAD P.4 0E1We ATLANTIC BEACH. FL 32233 EXPIRES: 8/11/2020 3 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL Notes: Roll off container company must be on City approved list. Approved list can be obtained at the Building Department at City Hall. Roll off container cannot be placed on City right-of-way. 4 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. 5 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 6 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL Notes: Any damage done to infrastructure must be repaired by Contractor. 7 PUBLIC WORKS OTHER PUBLIC WORKS CONDITION INFORMATIONAL Notes: This permit is to remove and replace existing driveway and walkway as is only. No additional impervious area can be added. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00 TOTAL:$125.00 Issued Date:2/13/2020 2 of 2 0.Ju1r , City of Atlantic Beach APPLICATION NUMBER 4s Building Department (To be assigned by the Building Department.) J r �)�� 800 Seminole Road :-,1,400 r� Atlantic Beach,Florida 32233-5445 �� ` Phone(904)247-5826 • Fax(904)247-5845 (7... x o�� EE-mail: building-dept@coab.us Date routed: ziI e) City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: G z4 (=�(,JA Lr4krs Cip Department review required Yes No Building Applicant: C(,0/0 G-2__ r�tanrnng&Zoning , 0 Tree'Administrator Project: Rvf { (v E--c.0A ( cp.ublic Works._ Public Utilities Public Safety Fire Services Review fee $ ill, Dept Signatur 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. I 'Denied. I 'Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING /� 2^ 1 --2._C., Reviewed by/i�l Date: �/' v' TREE ADMIN. Second Review: ['Approved as revised. ❑Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: I !Approved as revised. ['Denied. Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 ,-0-AnCity of Atlantic Beach ' APPLICATION NUMBER jrtE Building Department (To be assigned by the Building Department.) -• ' 800 Seminole RoadFEB�� Atlantic Beach, Florida 32233 5445 F�D 0 • t�up flyZ — (�Q_' Phone(904)247-5826 • Fax(904)247- .1-',0;119.r. E-mail: building-dept@coab.us i— Date routed: zit 0(7,e) City web-site: http://www.coab.us — - APPLICATION REVIEW AND TRACKING FORM cl Property Address: 1 Z4 J G(�/FL�KFS( tizpepartmeflt review required Yes No Building r----• Applicant: �CDK)C 6Z arming Zoning , Tree Administrator Project: Ave-P__, 0 P__,(v E-1,,L a( �ublic 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: 'Approved. I 'Denied. Not applicable (Circle one.) Comments: BUILDING v. PLANNING &ZONING Reviewed by02-4 -20 Date: TREE ADMIN. Second Review: I (Approved as revised. ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. F 'Denied. I 'Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 ,s Building Permit Application Updated 10/9/18 talk,, City of Atlantic Beach Building Department **ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY tt Ur IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us 7 � Job Address: 724 SELVA LAKES CIRCLE f Permit/Nu_mber: 0i--_,"y1 ) X Legal Description ��.I,,JC\ (.�),ke DD A r 4 3 L cm T- I z(c RE# l f Z02-7- Valuation 0Z-7-Valuation of Work(Replacement Cost)$2450 Heated/Cooled SF Non-Heated/Cooled ) • Class of Work: ❑New DAddition VAlteration krgepair ❑Move ❑Demo DPool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial VResidential F EB 7 2020 • If an existing structure,is a fire sprinkler system installed?: DYes IANo • Will tree(s)be removed in association with proposed project? EYes(must submit separate Tree Removal Permit) INo Describe in detail the type of work to be performed: DRIVEWAY WILL BE PAVED • Florida Product Approval# for multiple products use product approval form Property Owner Information Name MAUREEN MCCULLOUGH Address 724 SELVA LAKES CIRCLE City ATLANTIC BEACH State FL Zip 32233 Phone 9045370562 E-Mail maureenwndy@gmail.com Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company Qualifying Agent Address City State Zip Office Phone Job Site Contact Number State Certification/Registration# E-Mail Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Insurer OR Exempt❑ Expiration Date Application is hereby made to obtain a permit to do the work an. nstallations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all wor ill be performed to meet the standards of all the laws regulating construction in this jurisdiction.I understand that a separ. •• permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS, WELLS,POOLS,FURNACES, BOILERS,HEATERS,TANKS, • d AIR CONDITIONERS,etc. NOTICE: In addition to the requirements of this permit,there may be additional restrictions applica. • 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 RECO DI G YOUR NOTICE OF COMM// CEMENT. cam$ (Signatur of Owner r Agent) (Signature of Contractor) Signed and sworn to(or affirmed)before me this 1— day of Signed and sworn to(or affirmed) efore me this day of L'iCt0 (U(\ e CL1t>LJV\ ,by JENNIFER JOHNSTON • r% MY COMMISSION#GG 042984 ture of Notary) (Signature of Notary) • 1tlN' EXPIRES:October 27,2020 .▪>• ol�P i •%FOF F:�•� Bonded Thru Notary Public Underwriters [ ]Personally Known OR [(,}'Produced Identification [ ]Produced Identification i Type of Identification: �L ( t J 1-‘ S l<<Q/13 t Type of Identification: Owner Builder Affidavit **ALL INFORMATION , ,(7-51--_---A,„„ HIGHLIGHTED IN '`'` City of Atlantic Beach Building Department GRAY IS REQUIRED. j / 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 j 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 ISA LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904- 247-5826 OR BUILDING-DEPTWCOAB.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: 724 SELVA LAKES CIRCLE Owner Name: MAUREEN A MCCULLOUGH Phone Number: (904)537-0562 Mailing Address: SAME AS JOB ADDRESS City: ATLANTIC BEACH State: FL Zip: 32233 Notarized Signature of Owner 27:,-.,z (--e/-2,1-,A------ The foregoing instrument was acknowledged before met is -1day of D_ uC-fit , 20 )(,)in the State of Florida, County of D,4v c t I Signature of Notary Public [ J Personally Known OR [ oduced Identification �';7P;, c JENNIFER JOHNSTON r C f-'1,-,.,. MY COMMISSION#GG 042984 Type of Identification: 1 (-- �-( IU Q- ] 1 C t nJ A. ' EXPIRES:October 27,2020 c* ifnui - ��` �:;e��;oP� Bonded Thru Notary. Public Underwriters ---1 -------'-- Updated 10/24/18 �r= `; REVOCABLE ENCROACHMENT AGREEMENT 7' '� City of Atlantic Beach **ALL INFORMATION f ^ 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 MAUREEN MCCULLOUGH 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 ENHANCEMENT OF DRIVEWAY-DRIVEWAY WILL BE PAVED . 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 724 SELVA LAKES CIRCLE • 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 �liiaabil�ities are hereby assumed by the USER. // �.4..r. i �� Date Propert Owner/Agent (signed in presence of Notary Public) STATE OF FLORIDA, COUNTY OF DUVAL (� The foregoing instrument was acknowledged this day of I��L-b' K C,-r1 , 20 Li , by IA c,...:...—,S-2--<- \"C CIC tky aL--- , who personally appeared before me and (printed name of Signer) acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. _c) J--=._) 4:e.v:'.V., JENNIFERJOHNSTON Department Approval: g*: o w� .. MY COMMISSION#GG 042984 Signature of NotaryPublic, State of Florida ; EXPIRES:October 27,2020 g .��.a: [ ] Personally Known ,,,,r,j,,,,,, Bonded Thru Notary Public Underwriters 7 "If'" _ V- ��, i [ roduced Identification (Type) r L et( iv9,3 ,c t im - • - cott Williams, Public Works Director ,2'-�"2-11) H:\Applications&Forms\Word Documents\20180831 Revocable Encroachment Agreement.doa Revision Date:8/31/18 MAP SHOWING BOUNDARY SURVEY OF LOT 126 AS SHOWN ON MAP OF SELVA LAKES UNIT THREE AS RECORDED IN PLAT 800K 44, PAGES 60 THROUGH 608 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. FOR: SHAFFER AND SONS ENTERPRISES BEARING REFERENCE: BEARING SHOWN ON RIGHT—OF—WAY LINE HEREON IS THE SAME AS SHOWN ON THE ABOVE MENTIONED PLAT. CERTIFIED TO : MAUReaN McCUGLOUGN 84k'NETT 6/9A/ of j.4K5 /✓/GLE, All).. ME-TRe>pot./T,p&/ 7-17/..Ef �GeiAtekvey Co_ ' UNPLATTED AREA OF SECTION 17, eN TOWNSHIP 2 SOUTH, RANGE 29 EAST L O Ls,a 35.01 ' zf+csrs; 't N82'23'04"EtJ �c Scawien Ale.PA0 ,GPONGQiri _-t i L >'t•3`-':.': E 4 /6.2• ,a!'p�o�,rD� .J 3.9 r /,w vao`'�a N i NI • J i o J IN lf) kki . 0 (Dz Q cn cn (�, '` W W n N D �c Wwv t' a `' ).. t 4- N a.. N Q o �` m z Q s ti o o 0 r.3' T O N. CO FiI✓rsk FLooR o i pp"V V .wmp EL.(11.37) 1.1 [n �- FENCE ,. (0 •• ; . N 00 > 0 Z Z i. :a.o ^ • P.R.C. 75',./E4. Eq SE.NENT Cop/Clirf. . np y . Y (11 1, :ORiyI --- h Q Q S83'Q v • , .b' .W W /4'3.77• �, 5E7 de.is„/704 'WIT ,� /c�ssty) P.T. Q /iJ./2•1*-1 �Jw/ v SELVA LAKES CIRCLE (50' R/W) 'F/ /AL S./AVEY /2-/2- 95 o /orEa fauc/O -.Vie a 1-,42 i?O1vS. , fOW047/OA/ SURYE Y 9-80- 95 NOTE FOLJIJO Ahz /Rovs. REVISED 7-27-95 TO SHOW ALL HARDWOOD TREES 6" OR LARGER. I HEREBY CERTIFY THAT THIS SURVEY, PER ARMED UNDER MY RESPONSIBLE DIRECTION MEETS THE !' MINIMUM TECHNICAL STANDARDS FOR LAND SURVEYORS.•li'ACCORDANCE WITH CHAPTER 61G17-6, FLORIDA 'I LEGEND: , ' ADMINISTRATIVE CODE (PURSUANT TO SECTION 472.027, F'€ORIDA STATUTES), AND FURTHER CERTIFY THAT !I • FOUNo CONCRETE MONUMENr THERE ARE NO VISIBLE ENCROACHMENTS UPON THE SUB.ZCT PROPERTY EXCEPT AS SHOWN. !� • '2 SET IR IRON 1 '2 SET IRON - Ld +704 FLOODCERTIFICATE:r '� El N L. BOLDING RESTRICTION LINE r LOOD CERTIFICATE: THE LOT SHOWN HEREON IS IN FLOOR CLARSON AND ASSOCIATES, INC.11 : RAUI S L ANGLE ZONE `X' AS SHOWN 'N THE FLOOD INSURANCE RATE 1643 NALGO AVE, JACKSON vIllE, FL., 32207 I' A ARC LENGTH MAP, COMMUNITY PANEL NO 12,00'c -. 00010 , DATED P-15-39. I� CR ::FORD PC POINT OF cIJR'VATURE r � 1 j P T POINT Or I ANGENCY SURVEYED APRIL 19 _ , 1995. K • h/ / ,! RR.r, POINT 01- REvERSEOIOUCURVE •I F'.C.':. POINT or COMPOUND CURVE SCALE: 1" = 20' i 1 m FOUND R STEREO Silk VE YOk NO 23h`, FlORIOA ill R/W RJ(H1-OF-WAY FIELD 800K 537 PAGE 71 1 P.. :$�TI;IAL RECORDS VOLuuE 550 49 JOSE A. HILL