130 Main St ROW21-0006 Comcast CablesOWNER:ADDRESS:CITY:STATE:ZIP:
OCEANSIDE CHRISTIAN
CHURCH OF THE BEACHES
INC
PO BOX 330740 ATLANTIC BEACH FL 32233-0740
COMPANY:ADDRESS:CITY:STATE:ZIP:
SOUTHEAST UTILITIES 1 ENERGY PL PENSACOLA FL 32520
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170844 0000 ATLANTIC BEACH SEC H
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
130 MAIN ST RIGHT OF WAY SINGLE OR TWO
FAMILY RIGHT OF WAY
ROW - CABLE BORE for
COMCAST $0.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 PUBLIC UTILITIES UNDERGROUND WATER SEWER UTILITIES INFORMATIONAL
Notes:
2 PUBLIC UTILITIES UTILITY MAP INFORMATIONAL
Notes:
See attached Utility Map.
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: 1/19/2021
PERMIT NUMBER
ROW21-0006
ISSUED: 1/19/2021
EXPIRES: 4/19/2021
RIGHT OF WAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
TOTAL:
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 INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
7 PUBLIC WORKS AS-BUILT INFORMATIONAL
Notes:
Contractor must submit As-Built plans to City within 30 days after completion of project.
2 of 2Issued Date: 1/19/2021
PERMIT NUMBER
ROW21-0006
ISSUED: 1/19/2021
EXPIRES: 4/19/2021
RIGHT OF WAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
H:\Applications & Forms\Word Documents\201801001 Right-of-Way Easement Permit Application.docx Revision Date: 10/1/18
**ALL INFORMATION
HIGHLIGHTED IN GRAY IS
REQUIRED.
RIGHT-OF-WAY / EASEMENT PERMIT APPLICATION
City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address_________________________________________________ Permit Number________________________
Contractor Information
Company______________________________________________ Qualifying Agent_____________________________
Address______________________________________ City________________________ State______ Zip___________
Phone________________________________________ Email_______________________________________________
State Certification/Registration #_______________________________________________________________________
Architect_____________________________________ Phone____________________ Email______________________
Engineer_____________________________________ Phone____________________ Email_______________________
Workers Compensation Insurer ____________________________________ OR Exempt □ 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, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from said
street or easement or reset or relocated hereon as required by the Public Works Director and at the expense of the
Permittee unless reimbursement is authorized.
All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the
supervision of ____________________________________________________________________ (Project Superintendent)
with (Company Name) ________________________________________________Phone_____________________________
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 th e
manner satisfactory to the City.
A sketch of plans covering details of this installation, as well as a copy of a recent survey shall 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 actual construction in good faith within _______ days. If the beginning date is more than 60
days from date of permit approval then permittee must review the permit with the Public Works Director to make sure no
changes have occurred in the area that would affect the permitted 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 harmless 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 aforesaid rights and privileges.
The Public Works Director shall be notified 24 hours prior to starting work and again immediately upon completion.
_______________________________________________________________________________ Date________________________
Permittee (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 Permittee)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
__________________________________________________________ [ ] Personally Known
Signature of Notary Public, State of Florida [ ] Produced Identification (Type) _______________________
1/11/2021
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ALL PROPOSED UNDERGROUND CATV ROAD BORES WILL USE CITY APPROVED DIRECTIONAL BORE MACHINE, AS WELL AS WORK OPERATIO
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OF 7' BEYOND THE EDGE OF PAVEMENT. CONSTRUCTION
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