1483 Laurel Way DWAY20-0024OWNER:ADDRESS:CITY:STATE:ZIP:
QUINN JUSTIN T 1483 Laurel Way Atlantic Beach FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
Moderna Pavers 215 Stokes Landing Rd St. Augustine FL 32095
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170704 0020 HIDDEN PARADISE
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1483 LAUREL WAY DRIVEWAY SINGLE OR TWO
FAMILY DRIVEWAY
replace driveway with
pavers $2395.75
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.
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.
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.
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.
1 of 2Issued Date: 7/15/2020
PERMIT NUMBER
DWAY20-0024
ISSUED: 7/15/2020
EXPIRES: 1/11/2021
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
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
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 MAXIMUM DRIVEWAY INFORMATIONAL
Notes:
Maximum driveway width within the City right-of-way is 20 feet.
7 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
8 PUBLIC WORKS OTHER PUBLIC WORKS CONDITION INFORMATIONAL
Notes:
Right-of-way swale must be maintained and not altered.
2 of 2Issued Date: 7/15/2020
PERMIT NUMBER
DWAY20-0024
ISSUED: 7/15/2020
EXPIRES: 1/11/2021
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
1iJ"liiitoiiOJ'!:JJ,-\'I1Y OT AtlantiC Deacn DUllumg uepartment
800 Seminole Road, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us
··ALL INFORMATION
HIGHLIGHTED IN GRAY
IS REQUIRED.
Job Address: 1483 Laurel Way Atlantic Beach. FL 32233 Permit Number: ___________ _
Legal Description 54-9717-2S-29E .13 Hidden Paradise Lot 3 RE# 170704-0020
Valuation of Work (Replacement Cost) S---'2"'3"'9"'5,.,..7'--'5"-___ Heated/Cooled SF _____ Non-Heated/Cooled ____ _
• Class of Work : D New D Addition D Alteration -.¢>,epair D Move D Demo DPool D Window/Door
• Use of existing/proposed structure(s): D Commercial -.¢>,esidential
• If an existing structure, is a fire sprinkler system installed?: DYes DNo
• Will trppl,\ hp removed in association with nronosed nroiprt? n Yes Imust submit separate Tree Removal Permitl ~o
Describe in detail the type of work to be performed: Remove concrete driveway and walk. Replace with concrete pavers
Florida Product Approval # ___________________ for multiple products use product approval form
Property Owner Information
Name Justin Quinn Address 1483 Laurel Way
City Atlantic Beach State --,-F--=L~_ Zip 32233 Phone -'44=3"'-5"'5"'3"'-9"'9"'2"'9'--_____ _
E-Mail justin@bluesaltproperties.com
Owner o r Agent (If Agent, Power of Attorney or Agency Letter Required) ___________________ _
Contractor Information
Name of Company Moderna Pavers
Address 215 Stokes Landing Rd
Office Phone 904-537-0411
Qualifying Agent Justin Canova
City St Augustine State --,-F--"L~_ Zip 32095
Job Site Contact Number
State Certification/Registration # 'l.O -oD'D lS=if~'kMail justin@moderna-p-av-e-r-s.-c-om------------
Architect Name & Phone # ______________________ ,, ___________ _
Engineer's Name & Phone # _____________________ -,/L--______ ----,=-__ ,-_
Workers Compensation Insurer _______________ OR Exempt iIIlEJCpiration Date I --1 ~ -~ I
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 ATIORNEY BEFORE
RECORDING YOU OT E OF COMMENCEMENT.&: ' .(
_____ ---"""fi2:::t;:;L..:.,=~.Q0?J7/'Q07?J./:g<20Q;2~01..-~ oJ;-" 2 -'1
(5 ' nature of Owner or Agent ) / (Signature of Contractor)
Signed and sworn to (or affirmed) before me this __ day of Signed and sworn to (or affirmed) before me this __ day of
___ ~ __ ~,by _________ _ ___ ~ __ ~, by _________ _
(Signature of Notary) (Signature of Notary)
r 1 pp.r.'>nn~lIv Known OR r 1 Personal Iv Known OR
07/08/2020
H:\Applications & Forms\Word Documents\20180831 Revocable Encroachment Agreement.docx Revision Date: 8/31/18
REVOCABLE ENCROACHMENT AGREEMENT
City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
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
__________________________________________________________ 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 _____________________________________________________________________.
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 __________________________________________________________.
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______________________
Property Owner/Agent (signed in presence of Notary Public)
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this _________ day of ________________________, 20 ______,
by ______________________________________________________, who personally appeared before me and
(printed name of Signer)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
______________________________________ Department Approval:
Signature of Notary Public, State of Florida
[ ] Personally Known __________________________________________
[ ] Produced Identification (Type) ______________ Scott Williams, Public Works Director
**ALL INFORMATION
HIGHLIGHTED IN GRAY
IS REQUIRED.
Justin Quinn
Replace existing concrete driveway and walk with concrete pavers
1483 Laurel Way Atlantic Beach, FL 32233
2020-07-07
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $125.00
DWAY20-0024 Address: 1483 LAUREL WAY APN: 170704 0020 $125.00
PUBLIC WORKS PLAN REVIEW $25.00
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
ZONING PLAN REVIEW $100.00
ZONING REVIEW SINGLE AND TWO FAMILY
USES 001-0000-329-1003 0 $100.00
TOTAL FEES PAID BY RECEIPT: R12336 $125.00
Printed: Wednesday, July 15, 2020 4:48 PM
Date Paid: Wednesday, July 15, 2020
Paid By: QUINN JUSTIN T
Pay Method: CREDIT CARD 345427471
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R12336