885 Beach Ave DWAY20-0046 Driveway PacketOWNER:ADDRESS:CITY:STATE:ZIP:
TONEY EDWARD L P O BOX 440280 JACKSONVILLE FL 32222
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170243 0000 ATLANTIC BEACH
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
885 BEACH AVE DRIVEWAY SINGLE OR TWO
FAMILY DRIVEWAY CONCRETE DRIVEWAY $9680.00
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 DRIVEWAY APRON INFORMATIONAL
Notes:
All concrete driveway aprons must be 5 inches thick, 4000 psi, with fibermesh from edge of pavement to the property line. Reinforcing rods or mesh are
not allowed in the City right-of-way.
2 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.
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: 11/6/2020
PERMIT NUMBER
DWAY20-0046
ISSUED: 11/6/2020
EXPIRES: 5/5/2021
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 ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
4 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.
5 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
6 PUBLIC WORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
7 PUBLIC WORKS DECKING REMOVED INFORMATIONAL
Notes:
All old decking and debris must be removed from job site by Contractor.
8 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
2 of 2Issued Date: 11/6/2020
PERMIT NUMBER
DWAY20-0046
ISSUED: 11/6/2020
EXPIRES: 5/5/2021
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $125.00
DWAY20-0046 Address: 885 BEACH AVE APN: 170243 0000 $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: R14058 $125.00
Printed: Friday, November 6, 2020 2:38 PM
Date Paid: Friday, November 06, 2020
Paid By: TONEY EDWARD L
Pay Method: CREDIT CARD 393067827
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R14058
I I I
I I I
I I I
~+; CENTRALSQUARE
Building Permit Application
I i City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233
Phone: {904) 247-5826 Email: Building-Dept@coab.us
Updated 10/9/18
**ALL INFORMATION
HIGHLIGHTED IN GRAY
IS REQUIRED.
Job Addre ss: 'i{<j 1;;" ,3e;(¾C H AvcN lie,,, t/TL1JA1ne /P>60:Cil Permit Number: D..PA'-{ ZO ,,,. 004 (c,
I P L ' ' 3 · _
Legal Description d:r,A-el-le..D RE# 1702.4 3 -000 0
Valuation of Work (Replacem ent Cost)$ °!; V fbO . e1o Heated/Cooled SF ____ Non -Heated/Cooled __ ~ ___ _
• Class of Work: □New □Ad dition ~Alteration □Re pair □Move l!Demo □Pool □Window/Door
• Use of existing/proposed structure(s): □C ommercial ~esid entia l
• If an existing structure, is a fire sprinkler sys tem instal led?: □Yes □No
• Will trees be removed in association with ro osed ro·ect? □Yes mu st subm it se arate Tree Removal Permit
Florida Product Approv al # __________________ for multiple products use product approva l form
Property Owner Information
Name BJ>wlfR.JJ c:;,,:rol'i,V Ta N6t_. Addre ss ~-.BaAeH AVGttJL.1/E.,
City /lq .. hNTI e. /3Bf!C. /-I State i~ '-Zip 3~..iil 3 3 Phone (90 <IJ 75-q -t>6 71
E-Mail J6'3:Yl 1:. ne:.y/i>) lt>t.ll.5oLL'tb,nP+
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 & Phon e# _________________________________ _
Engineer's Name & Phone# _________________________________ _
Work ers Compensation Insurer _______________ OR Exempt □ Expiration Date _______ _
Application is hereby made to obtain a permit to do the work and installation s as indicated . I certify t hat no work or installation ha s
co m menced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulati ng
construction in thi s juri sdiction . I understand that a separate permit must be sec ured for ELECTRICAL WORK , PLUMBING , SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS , TANKS, an d AIR COND ITION ERS, etc . NOTICE : In additi o n to t he requirements of t his
pe rm it, there may be additional restriction s app licab le to this property that may be found i n t he p ubl i c record s of t his county, a nd
there may be additional permits required from othe r governmenta l entities such as water management districts, state agencies, or
federal agencies. ••
OWNER'S AFFIDAVIT : I certify that all th e foregoing info rmation is accura te and that all work wi ll be done in compliance with all
ap pl icable 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 ING YOU NOTICE OF COMMENCEMENT.
(Signature of Contractor)
Signed and sworn to (or ·
Odohe.1-' .:l-o ;)..£
Signed and sw orn to (~r affirmed ) before me this __ day of
------~by __________ _
l~¼~i!:~T~\ MY C~MMISSION # GG 302565
·•· •,o: ...An ~-:ii EXPIRES: December 4, 2023
y-i...ersona lly Know n P.J.';f_o,;,._?,t~' BondedThnl NotaiyPublic\JndelWriter1
[ ] Produced ld enti ficli·•••i'"~' A~~a~aaiiiillliiaiiiiaa-'1
Typ e of Id entification: _____________ _
{Signature of Notary)
[ ] Persona ll y Known OR
[ ] Produced Id entification
Type of Identification : _____________ _
KAP SHOWING BOUNDARY SURVEY OF
(L.[GAL DESCRIPTION PER OFFIOAL RECORDS VOLUME 5819, PAGE 803)
A PART OF HOTEL RESERVATION AS SHOWN ON MAYP0RT TERMINAL C0MPANYS MAP OF ATLANTI C
BEACH, AS RECORDED IN PLAT BOOK 5, PAGE 64, OF THE CURRENT PUBLIC RECORDS OF DUVAL
COUN1Y, FLORIDA AND PART OF LOT 20, CLUB MANOR, ACCOROlNG TO PLAT THEREOF RECORDED
IN PLAT BOOK 25, PAGE 62, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUN1Y, FLORIDA ,
BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS :
COMMENCE AT THE SOUTHEAST CORNER OF LOT 20, CLUB MANOR, (X CUT IN CONCRETE) AT PLAT
BOOK 25, PAGE 62, THENCE RUN NORTHERLY ALONG SAID CONCRETE BULKHEAD FOR 70 FEET TO
A CROSS CUT IN THE CONCRETE BULKHEAD TO A POINT HEREINAFTER CALLED 'POINT A", THENCE
RUN SOUTHERLY ALONG AFORESAID BULKHEAD FOR 70 FEET TO THE POINT OF COMMENCEMENT,
THENCE SOUTH 55· 32' 15" WEST FOR 156 .95 FEET, THENCE NORTH 04" 12' 55" WEST FOR 51.68
FEET TO AN EXISTING CONCRETE CURB FOR THE POINT OF BEGINNING, THENCE NORTHEASTERLY
FOR A CHORD DISTANCE OF 22.32 FEET TO THE INTERSECTION WITH A POINT BEARING SOUTH as·
32' 15" WEST AND 149.26 FEET DISTANCE FROM POINT A, THENCE NORTH as· 32' 15" EAST FOR
149 .26 FEET TO POINT A, THENCE NORTH 16" 32' 54" WEST ALONG CENTER OF AFORESAID
BULKHEAD FOR 30.68 FEET TO AN (X) CUT IN CONCRETE, THENCE SOUTH as· 32' 15" WEST FOR
157.65 FEET AND TO THE EASTERLY RIGHT OF WAY LINE OF BEACH AVENUE, AS NOW
ESTABLISHED, THENCE SOUTH 4" 27' 45" EAST AND ALONG THE EASTERLY BOUNDARY LINE OF
BEACH AVENUE, AS NOW ESTABLISHED, 30 FEET, THENCE SOUTH 4· 12' 55" EAST AND ALONG THE
EASTERLY BOUNDARY LINE OF BEACH AVENUE, AS NOW ESTABLISHED , 18.23 FEET TO THE POINT
OF BEGINNING.
(LEGAL DESCRIPTION PREPARED BY THE UNDERSIGNED)
A PART OF HOTEL RESERVATION AS SHOWN ON MAYP0RT TERMINAL C0MPANYS MAP OF ATLANTIC
BEACH, AS RECORDED IN PLAT BOOK 5, PAGE 64 OF THE CURRENT PUBLIC RECORDS OF DUVAL
COUN1Y, FLORIDA, AND A PART OF LOT 20, CLUB MANOR ACCORDING TO PLAT THEREOF
RECORDED IN PLAT BOOK 25, PAGE 62, OF SAID CURRENT PUBLIC RECORDS, AND BEING MORE
PARTICULARLY DESCRIBED AS FOLLOWS:
FOR A POINT OF BEGINNING COMMENCE AT THE NORTHWESTERLY CORNER OF SAID LOT 20, CLUB
MANOR AND RUN SOUTH 85" 32' 15" WEST, ALONG THE NORTHERLY RIGHT OF WAY LINE OF CLUB
DRIVE (A 50 FOOT RIGHT OF WAY), A DISTANCE OF 7.80 FEET TO THE SOUTHWESTERLY CORNER
OF LANDS RECORDED IN SAID CURRENT PUBLIC RECORDS IN OFFICIAL RECORDS BOOK 5819, PAGE
803, AS FOUND MONUMENTED AND IN POSSESSION ; THENCE NORTH 04· 27' 45" WEST, ALONG THE
WESTERLY LINE OF SAID OFFICIAL RECORDS BOOK 5819, PAGE 803 AND AN EASTERLY LINE OF
LANDS RECORDED IN SAID CURRENT PUBLIC RECORDS IN OFFICIAL RECORDS BOOK 3876, PAGE
450, AS FOUND MONUMENTED AND IN POSSESSION, A DISTANCE OF 30.00 FEET TO THE
NORTHWESTERLY CORNER OF SAID OFFICIAL RECORDS BOOK 5819, PAGE 803; THENCE NORTH as·
32' 15" EAST, ALONG THE NORTHERLY LINE OF SAID OFFIOAL RECORDS BOOK 5819 , PAGE 803
AND A SOUTHERLY LINE OF SAID OFFICIAL RECORDS BOOK 3876, PAGE 450 AS FOUND
MONUMENTED AND IN POSSESSION , A DISTANCE OF 164.42 FEET TO A POINT ON AN EXISTING
BULKHEAD; THENCE SOUTH 04" 13' 28" EAST, ALONG SAID EXISTING BULKHEAD, A DISTANCE OF
30.00 FEET TO THE SOUTHEASTERLY CORNER OF SAID OFFICIAL RECORDS BOOK 5819, PAGE 803;
THENCE SOUTH 85" 32' 15" WEST, ALONG THE SOUTHERLY LINE OF SAID OFFICIAL RECORDS BOOK
5819, PAGE 803, AND ALONG THE NORTHERLY LINE OF SAID LOT 20, CLUB MANOR , A DISTANCE
OF 149 .26 FEET TO A POINT ON A CURVE; RUN THENCE IN A SOUTHWESTERLY DIRECTION ALONG
THE ARC OF A CURVE CONCAVE NORTHWESTERLY AND HAVING A RADIUS OF 80.00 FEET, AN ARC
DISTANCE OF 13.35 FEET TO A POINT ON THE EASTER LY RIGHT OF WAY LINE OF BEACH AVENUE
(A 50 FOOT RIGHT OF WAY), SAID ARC SUBTENDED BY A CHORD BEARING AND DISTANCE OF
SOUTH 28" 45' 57" WEST, 13.34 FEET; THENCE NORTH 04" 07' 14" WEST, ALONG LAST SAID
EASTERLY RIGHT OF WAY LINE. A DISTANCE OF 11 .16 FEET TO THE POINT OF BEGINNING .
CERTIFIED JO:
EDWARD L. & JOAN T. TONEY
:1~
rJ
---~!r.
REVOCABLE ENCROACHMENT AGREEMENT
City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
**ALL INFORMATION
HIGHLIGHTED IN GRAY
IS REQUIRED.
REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation organized and
ate of Florida, hereinafter referred to as 11 CITY11 and
of Atlantic Beach, Florida, hereinafter
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 de scribed in the City of Atlantic Beach .
This work is generally described as d(~
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 (!J3lz BMt-1,,, ht,nue;_... .
• 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 USE R's sole expense ,
any and all material nece ssarily 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 .
f!:,((,wf1{rv,;,,~,,,.
Property ~r/Agent (signed in presence of Notary Public)
Date_~l~D_-_5_'_;;:L.O ___ _
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this day of __ ()_C=-· ._f--o_s_~ ___ _, 20 ~I
by ___ fl]_.._A----'--/Z_t_li>-'-J--=£"-.,__/5_e,J="-_S_&_N _________ __,, 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:
Scott Williams , Public Works Director
Owner Builder Affidavit
City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247 -5826 Email: Building-Dept@coab.us
**ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.
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 DON E 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 RES IDENCE 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 BUil T FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUI LT YOU RSE LF WITHIN ON E YEA R AFTER THE
CO NSTR UCT ION IS COMPLET E, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHI CH
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.
11. INJURY LIABILITY ; SINCE OWNERS MAY BE LIABLE FOR INJURI ES TO WOR KERS THEY HIRE , THE BUILDING DEPARTMENT
SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED ..
111. 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 CIRCUM STANCES. 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 "C ERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CERT IFI CAT E" TO ASCERTAIN IF A PERSON IS A LICENSED CONT RACTO R. CONTACT THE BUILDING DEPARTMENT (904-
24 7-5826 OR BUILDING -DEPT@COAB .US ) IF IN DOUBT .
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAV E READ THE ABOVE DISCLOSU RE STATEMENT AND THAT I
COMPLY WITH AL L TH E REQUIREMENT S FOR T HE ISSUAN CE O F AN OWNER -BUILDER PERMIT .
Job Ad dress: '6'?5' 'i3Gl½~/i t/v6/\IU6 4-n .. .A1'.I r1(!, &etJcH PL .3 ;;l.;l 33 ) I
Owner Name : Jol}:1'1 M. To Nc'f Phone Number: c109J 7b-c, -Olp'/ I
Mail ing Ad dress : <385"" ~Gfl-ei-1 /i-V£1\1UC City:J'tru\.1'rn C 13~1 State: FL Zip: :?.a«:3 J
Noto,freds;gnotu,eofOwne, ~Cl,-;,<.__, IJ1 Y~
The ~egoin~ in st rum e nt was acknowledged before me tks .:q :!>.._\a ay of Od-a!u..-, 20 ..2.s.>, in th e State of Florida, County
of ..D" ,/A:-\
........ ,..... MARION E BENSON tJ~l,) MY COMMISSION # GG 362565
\t~·~«.-: EXPIRES: December 4, 2023
··<tii°f:f~?,'t•·· Bonded ThnJ Notaty Public: Undenmtels
\;nr. ",~,.,_,_~ C _D Signature of Notary Publi c -----'ll/-u.+--=-~"'---"'-==-='--=---c_......::c....---'-~--'=:::....<..=--=c...:..=:ec.._ ____ _
~ersonally Known OR [ ] Produced Identification
Type of Identifi ca tion : ____________________ _
Updated 10/24/18
RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION
City of Atlantic Beach
800 Seminole Road , Atlantic Beach, FL 32233
**ALL INFORMATION
HIGHLIGHTED IN GRAY IS
REQUIRED.
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address F 5' B6ltt:. H 4\J&Nut..
Contractor Information
Company Jot,N ToNc t
Address <g<g o~ 736AeJ::I B v~ u ~
Phon e ( qoq) 15'9-0le 1 I
Permit Number ------------
Qua l ifying Agent_O~W.~1/t~)~~-~------
City /1:TL /)NII C Batc>l,tate J~L Zip _3;?J3.3
EmailJ'oaniD n e'-(@he j sou.th. net
State Certification/Registratio n # _______________________________ _
Architect rei,'1 0vrwhk:'t l<L-A
Engineer __________________ Phone _~---_-_-_-_______ Email __________ _
Workers Compensation In surer OR Exempt 14 Expiration Date ____ _
• Permittee declares that prior to filing this application they have ascertained the location of all existing utilities, both aerial
and underground and the accurate locations are shown on the sketches.
• Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation, alteration or
relocation of all, or any portion of said street or easement as determined by the Public Works Director, any or all said poles,
wires, pipes, cable s or other facilities and appurtenances authorized hereunder, shall be immediate ly removed from sa id
street or easement or reset or relocated hereon as required by the Public Wo rks Dir ecto r and at the expense of the
Permittee unless reimbursement is authorized .
• All work sha ll meet City of Atlantic Beach or Flo rida Department of Transportation Standards and be performed under the
supervision of ~l'1,~~ (Project Superintendent)
with (Company Name) ~ 0{vJb, Phone t}04· ??3, I~
• All materials and equipment shall be subject to inspection by the Public Works Director.
• All city property shall be restored to its original condition as far as practical, in keeping with City specifications and the
manner satisfactory to the City .
• A sketc h of plan s covering detail s of this installation, as well as a copy of a recent survey sha ll be made a part of this permit.
Calculations showing any increase in impervious area on owner's lot or in the City right -of-way are to be included with
this application.
• The permittee shall commence actua l con struction in good fa ith withi n ___ days. If the beginning date is more than 60
days from date of permit approval then permittee must revi ew the permit with the Pub lic Works Director to make sure no
changes have occurred in th e area that would affect the pe rmitted construction.
• It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right,
title and interest in the land to be entered upon and used by the holder, and the holder will, at all times, assume all risk of
and indemnify, defend and save harmles s the City of Atlantic Beach from and against any and all loss, damage and cost of
expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesai d rights and privileges .
The Public Works Di rect or shall be n ified 24 hours prior to starting work and again immediately upon completion .
--1--=--""'-----'--L----'-".____,__...,~'-"""+-c.~---,,.q..;"""-='-=--.,__.~c..::....::'---7F'---------Date Io -;,.../ -.)..s:,
STATE OF FLORIDA, COUNTY OF DU VA L
The foregoing instrument was acknowledged this 9'1 .:rt-day of Oc\-o QJl.._ 20 ,;La>
by J"< tf-N /Q NC.. who personally appeared before me and
(printed name of Permittee ) ,,, •••. ,..... MARION E. BENSON
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it (..,.,!it,,;1 MY COMMISSION# GG 362565
m 1~.~-~J EXPIRES: Oecember-4, 2023 E._ '•1.';f,;;;...o~~-· Bonded Thru NotaryPublicUnderwitters
~ ~ -----~ ~ersona I ly K,Jlu~w~~"'ii""iiii'' iiiiiiiiiiii~iiiii~iiiiiiiiiiiiiiiliiailiiiiiiiii"
Sig nature of Notary Pub li c, State of Florida [ ] Produced Ide ntifi ca tion (Typ e) _________ _
H:\Applica ti ons & Form s\Word & Excel Docum ent Originals\201801001 Right -of-Way Easement Permit App lication.docx Revision Date : 10/1/18
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• ROCK SALT FINISH CONCRETE DRIVEWAY
" / 1/4" -3/4 " VARIABLE PITTED SURFACE
• 4'• OR
• 1" BEACH MIX SHELLS .PRESSED SMOOTtil Y
C INTO WET CONCRUE . .
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2" -6" SMOOTH FINISH PICTUR E FRAME BAND
4 X 9 BRIC!< BAND, MORTAR OR
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2" -6" SMOOTH FINISH PIC TURE FRAME BAND
4 X 9 BR ICK BAND , MITER CORNERS
ANO INTERSECTIONS
® PLAN @ BRICK BAND / TABBYCONCRETE DRIVEWAY
L4
BRICK PAVER INSET
AS SPECIFIED
"· •. i
<1 . . .
8"
6" CONCR ETE DRIVEWAY, 3000 PS I
w/ FIBERMESH ADDITIVE
BEACH SHELL MIX FINISH
2" -6 " SMOOTH PICTURE FRAME BORDER
EXISTING CO MPACTED SUBGR ADE
FREE OF ORGANICS & CONSTRUCTION DEBRIS
@ SECTION @ BRICK BAND / CONCRETE DRIVEWAY
L
g" VARIES
6" D X 12' WIDE FIBERMESH
3000 j:,s( co#c. !mMWAY
BEACH SHELL MIX FINISH.
2" SMOOTH BORDER
(cr) SECTION @ BRICK BAND ORIVEWA Y EDGE
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" 4 • 4
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• 4
4
• ROCK SALT FINISH CONCRETE DRIVEWAY
" / 1/4" -3/4" VAR IABLE PITTED SURFACE
.4 4', 0
• ~ r'' BEACH ~rx SHELLS PRESSED SMOOTHL y
[1.\1.TO WET CONCRETE ' .
4 •
4 "
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2" -6" SMOOTH fJN/SH PICTURE FRAME BAND
4 X 9 8R1CK SAND , MORTAR OR
+--1-,--EPOXIED INTO PLACE
2" -6" SMOOTH FINISH PICTURE FRAME BAND
4 X 9 BRlCK BAND, M1TER CORNERS
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