1918 Oak Circle Revision Submittal Revision Request/Correction to Comments **ALL INFORMATION
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" City of Atlantic Beach Building Department GRAY IS REQUIRED.
%Mir 800 Seminole Rd, Atlantic Beach, FL 32233
it 9"'
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
❑ Revision to Issued Permit OR LYJ Corrections to Comments Date:
Project Address: / ')5 6,4,4CI pc-j /9-z
Contractor/Contact Name: pA*ActreA
Contact Phone: "4 382_ 953 Email: K.3223B(9cediittc,•C,s )
Description of Proposed Revision/Corrections:
/110 . t 1 rze-irn A►-ed fie. ` ` p
I J( ,M, -e t I� affirm the revision/correction to comments is inclusive of Eek{(printed
LLL ""'(printed name) C v C
1)
• Wil proposed revision/corrections add additional square footage to original submittal? AUG 2 4 2021
LJ No ❑ Yes (additional s.f.to be added: )
BY:
• Wjll-broposed revision/corrections add additional increase in building value to original submittal?
No ❑*yes (additional increase in building value:$ ) (Contractor must sign if increase in valuation)
*Signature of Contractor/Agent: r�
(Office Use Only)
❑ Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due$
Revision/Plan Review Comments
Department Review Required:
Building
Planning&Zoning Reviewed By
Tree Administrator
Public Works
Public Utilities
Public Safety Date
Fire Services Updated 10/17/18
1w-1- r', TREE & VEGETATION AFFIDAVIT FOR INTERNAL OFFICE USE ONLY
1-7 �'
_ ,6 City of Atlantic Beach PERMIT#
A 111 Community Development Department
"'ton
/ 800 Seminole Road Atlantic Beach, FL 32233
L o;� % (P) 904-247-5800
SITE INFORMATION
ADDRESS /5/e (0,,.4< c, ,,,le
SUBDIVISION .SgIV& inG /ri, BLOCK U4I1 /2 4 LOT I D
RE# /720 2a — / 2_52_ VIESIDENTIAL ❑ COMMERCIAL ❑ OTHER
APPLICANT INFORMATION
NAME kg/ _ /6et/<"/e4 PHONE# 90 r- L 97
ADDRESS )y l 04_ a !r c- C� gleri
CITY l LU,,, (L .41 STATE 1_ ZIP CODE 22-23
EMAIL 1491 2223, ,�AbV C.0' ryi P2KN NER ❑ LEGAL AUTHORIZED AGENT
I affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation", of
the Municipal Code of Ordinances for the City of Atlantic Beach Florida and/or I have participated in a pre-
application meeting with the Administrator of those regulations. Subsequently, I affirm that no regulated
trees and no regulated vegetation will be damaged, destroyed and/or removed from the above-described
property and/or adjacent properties including right-of-way.
I
HER ev RTIF THAT ALL INFORMATION PROVIDED IS CORRECT:Signature of Property Owner(s)or Authorizes Age
/Ai /
/Od'e7// g Zr P-02-
SIGN'�1!"" OF APPLICANT RINTOR iPE NAME D ,TE
SIGNATURE OF APPLICANT(2) PRINT OR TYPE NAME DATE
Signed and sworn before me on this 29 day of A U C7 UST , 20 2/ by State of Florida
County of DV V A 1.—
Identification
Identification verified: Florida Driver's H c i c
Oath Sworn: es /7/1/0 "-
si'!r'•'![ : GILE };;, CHRISTIAN SNotary Signature
.: ,!‘ ..t MY COMMISSION#HH 117153
-��4 EXPIRES:April 13,2025
' ar'� Bonded Thu Now/Pubic Undotw Iters My Commission expires A prr I 13, 2-07-5
04 TREE AND VEGETATION AFFIDAVIT 03.01.2018
j_� ermit Reviews
r
City of Atlantic Beach
Permit Number: DWAY21-0032 Description: PAVER DRIVEWAY AND WALKWAY
Applied:8/13/2021 Approved: Site Address:1918 OAK CIR
Issued: Finaled: City,State Zip Code:Atlantic Beach,Fl 32233
Status:RECEIVED Applicant:<NONE>
Parent Permit: Owner: KLEINLIVING TRUST
Parent Project: Contractor:<NONE>
Details:
SENT DATE RETURNED
DUE DATE TYPE CONTACT STATUS REMARKS
Review Group:AUTO
8/13/2021 8/13/2021 SUBMITTAL Permit Tech APPROVED
COMPLETENESS
Notes:
ONE ATTACHMENT
8/13/2021 8/20/2021 8/27/2021 ZONING Zoning DENIED
Notes:
If any trees 8 inches in diameter and great are planned for removal,please submit a tree removal permit application.If no trees are being removed,
please submit a tree and vegetation affidavit.
8/13/2021 8/23/2021 8/27/2021 PUBLIC WORKS Public Works APPROVED
W/CONDITIONS
Notes:
See Conditions of Approval that will be printed on Permit.
Printed:Tuesday,24 August, 2021 1 of 1 \'®, CENTRALSQUARE