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760 Sherry Dr DEMO21-0028 DemoOWNER:ADDRESS:CITY:STATE:ZIP: AF AB VENTURE LLC 1738 SELVA MARINA DR ATLANTIC BEACH FL 32233 COMPANY:ADDRESS:CITY:STATE:ZIP: REALCO RECYCLING 8707 SOMERS RD JACKSONVILLE FL 32226 TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 170395 0000 SALTAIR SEC 03 JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 760 SHERRY DR DEMO COMPLETE DEMO HOUSE $10000.00 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 METER BOX SEWER CLEAN OUT INFORMATIONAL Notes: Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. 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 3Issued Date: 9/14/2021 PERMIT NUMBER DEMO21-0028 ISSUED: 9/14/2021 EXPIRES: 3/13/2022 DEMO PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 3 PUBLIC UTILITIES RT1 SEWER CLEANOUT INFORMATIONAL Notes: A sewer cleanout must be installed at the property line. Cleanout must be covered with an RT1 concrete box with metal lid. Cleanout to be set to grade and visible. 4 PUBLIC UTILITIES RPZ BACKFLOW INFORMATIONAL Notes: A reduced pressure zone backflow preventer must be installed if irrigation will be provided or if there is a private well on the property. Backflow preventer must be tested by a certified tester and a copy of the results sent to Public Utilities. 5 PUBLIC UTILITIES DISCONNECT AND CAP INFORMATIONAL Notes: Disconnect and cap water and sewer lines. 6 PUBLIC UTILITIES INSPECTION PRIOR TO DEMOLITION INFORMATIONAL Notes: 7 PUBLIC UTILITIES ADDITIONAL COMMENTS PUBLIC UTILITIES INFORMATIONAL Notes: 8 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. 9 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. 10 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. 11 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration, including sod, is required. 12 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 13 PUBLIC WORKS DOCUMENT IMPERVIOUS AREA INFORMATIONAL Notes: Strongly suggest thorough documentation of impervious areas be recorded. 2 of 3Issued Date: 9/14/2021 PERMIT NUMBER DEMO21-0028 ISSUED: 9/14/2021 EXPIRES: 3/13/2022 DEMO PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT DEMOLITION 455-0000-322-1000 0 $100.00 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $129.00 14 PUBLIC WORKS SLAB DRIVEWAY REMOVAL INFORMATIONAL Notes: Slab and driveway to be fully removed. 15 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL Notes: Any damage done to infrastructure must be repaired by Contractor. 16 PUBLIC WORKS DEBRIS INFORMATIONAL Notes: Roadway must be kept free of debris, mud, dirt, etc. during and after project by Contractor. All holes that have been dug and any property that has been disturbed must have barriers and flags placed during project by Contractor. 3 of 3Issued Date: 9/14/2021 PERMIT NUMBER DEMO21-0028 ISSUED: 9/14/2021 EXPIRES: 3/13/2022 DEMO PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 DESCRIPTION ACCOUNT QTY PAID PermitTRAK $129.00 DEMO21-0028 Address: 760 SHERRY DR APN: 170395 0000 $129.00 BUILDING $100.00 DEMOLITION 455-0000-322-1000 0 $100.00 PUBLIC WORKS PLAN REVIEW $25.00 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 STATE SURCHARGES $4.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL FEES PAID BY RECEIPT: R17125 $129.00 Printed: Tuesday, September 14, 2021 11:33 AM Date Paid: Tuesday, September 14, 2021 Paid By: REALCO RECYCLING Pay Method: CREDIT CARD 511933731 1 of 1 Cashier: CG Cash Register Receipt City of Atlantic Beach Receipt Number R17125 Final Plumbing Final Electrical Final HVAC CC Final Final Building* Swimming Pool Steel Swimming Pool Safety Electrical Grounding & Bonding Swimming Pool Final (Bldg) Swimming Pool Final (PW) Formed Columns/ Beams* Masonry Cell Fill Structural Steel* OTHER: OTHER: OTHER: OTHER: OTHER: Power Pole Silt Fence Piers/ Stem Walls Underground Plumbing Underground Electric Foundation/ Footing Slab** Retaining Wall Footing Driveway Sewer (Building Dept) Sewer Tap (Utilities Dept) Rough Electric* Rough Plumbing/ Top Out* Rough Mechanical* House Wrap Wall Sheathing Roof Sheathing Tie-down Framing Connections Rough Framing Roofing In Progress Window/Door In-Progress Insulation Ceiling Insulation Wall Exterior Lath Stucco Scratch Coat Exterior Siding In-Progress Brick Flashing & Ties Early Power Gas Rough Gas Final* * When all rough electric, plumbing, mechanical are complete but before any work is covered up. * When all gas piping is complete and wallboard is installed but before gas is attached to any appliance. All outlets must be capped and pipe pressurized at a minimum of 15 lbs. * For new living space: When all construction work including electrical, plumbing, mechanical, exterior finish, grading, required paving and landscaping is complete and the building is ready for occupancy, but before being occupied Additional inspections may apply to your project if your project contains these elements: INSPECTIONS REQUIRED FOR BUILDING PERMITS To verify compliance with building codes, inspections of the work authorized are required at various points of the construction. The following inspections are typically required for residential projects: Date: Initial: Date: Initial: _____________________________________________________ Permit Type ____________________________________________________ Permit No. __________________________________________________________ Job Address ____________________________________________________ Contractor POST THIS CARD WITH PERMITS AND PERMIT DOCUMENTATION IN FRONT OF BUILDING Construction Hours per City Code: 7am—7pm Weekdays; 9am—7pm Weekends Building Department Public Works/Utilities Fire Department Phone: 904-247-5826 Phone: 904-247-5834 Phone: 904-630-4789 Fax: 904-247-5845 Fax: 904-247-5843 Fax: 904-630-4203 * When forms and reinforcing steel, anchor bolts, sleeves and inserts, and all electrical, plumbing and mechanical work is in place, but before concrete is poured. * When all structural steel members are in place and all connections are complete, but before such work is covered or concealed. ** FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION 1 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 (904) 247-5800 BULLETIN 4-18 To: All Permit Applicants. From: Dan Arlington, CBO City Building Official Date: October 30, 2018 Re: DEMOLITION OF STRUCTURES. Please use the general Building Permit Application Form for Demo Permits and include a Site Management Plan, showing all structures to be demolished and to remain, erosion and sediment control plans with installation details, proposed use of the right-of-way and parking; a property survey; and the contractor’s documents needed to obtain a building permit. 1. It is the responsibility of the contractor to: a. Contact JEA to disconnect electric power. b. Disconnect and cap off water, sewer, and gas lines. The contractor must call to schedule an inspection of the disconnected and capped water and sewer lines prior to demolition. c. Start a Construction Water Account. (See Items 8 – 11 on Page 2) 2. The demolition contractor must provide written notice to the owners of all adjacent properties, not less than 10 Days prior to start of demolition, per FBC-EB, Section 1502. Adjacent properties must be protected from damage during excavation, demolition, and construction activities. 3. Silt fences must be in place and approved by Public Works before beginning demolition. 4. All underground tanks, concrete slabs and foundations must be removed with the buildings, unless otherwise approved by the City. The site should be left graded and clean for Final Inspection. 5. Removal of any trees requires a separate Tree Removal Permit, per COAB Code Of Ordinances, Section 23-21. 2 6. Protection of trees and vegetation during construction is required, per COAB Code Of Ordinances, Section 23-32. 7. Prior approval, from the Building Department, is required before blocking any part of the right-of-way or side walk. Dust and wind-borne debris generated from the demolition of a structure is considered unsafe and a hazard to the public health, safety, and welfare of residents in the surrounding areas. When demolishing a structure, the following steps are required to ensure that the minimum dust and debris leaves the property: 8. At least two hoses, with nozzles, capable of reaching to all areas of the property must be on site with an adequate water supply. 9. The structure must be sprayed with water for one hour before demolition begins. 10. The hoses must be used continuously during demolition, wetting down the structure, the debris pile, and truck beds when being filled. ASBESTOS. 11. All roofing and siding made from asbestos containing materials (ACM) are considered friable and must be removed from the structure, following NESHAP Guidelines, before demolition begins. This includes all commercial and one and two family residential dwellings. Please call for a Pre-Demolition Inspection, before demolition begins, and a Final Inspection, when demolition is complete. NOTES. 1. A construction water account can be obtained at the Water Department in City Hall. 2. Any new residence using the original building sewer piping shall be internally examined to verify correct size, slope, is not broken or obstructed, and a clean out at the property line with an RT-1 concrete cover is required to comply with current City requirements. 10/30/18, 12/28/18, 10/23/2020 PUBLIC UTILITIES PLAN REVIEW COMMENTS Date: Application #: Project Address: APPLICATION TRACKING COMMENTS Check Box to Add Comment Check Box to Print Underground Water Sewer Utilities Avoid damage to underground water and sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is needed, call 247-5878.   Meter Boxes Sewer Cleanout Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible.   RT1 Sewer Cleanout A sewer cleanout must be installed at the property line. Cleanout must be covered with an RT1 concrete box with metal lid. Cleanout to be set to grade and visible.   RPZ Backflow A reduced pressure zone backflow preventer must be installed if irrigation will be provided or if there is a private well on the property. Backflow preventer must be tested by a certified tester and a copy of the results sent to Public Utilities.   Sensus Touch-Read Meter Plans note the building will be unsprinkled. If plans change, any fire line installed must be metered with a Sensus touch-read meter in a properly sized vault and an appropriate backflow preventer installed. Backflow preventer must be tested by a certified tester and a copy of the results sent to Public Utilities.   Fire Sprinkler Backflow Requirement If fire sprinkler system is provided, call 247-5878 for backflow requirements. At a minimum, will require a double check backflow preventer.   Fire Line Meter Fire lines must be metered with a Sensus touch-read meter. Meters larger than 2” must be installed in a vault as noted in JEA specifications.   Utility Map See attached Utility Map.   Disconnect & Cap Disconnect and cap water and sewer lines.   Inspection Prior MUST call the Inspection Line at 247-5814 to request an inspection of the disconnected and capped water and sewer lines PRIOR to demolition.   Utility Inspections All water & sewer utility connections must be inspected prior to cover up. Please call the inspection line at 247-5814 to schedule inspections 24 hours in advance. Failure to schedule utility connections may result in failed inspections and additional fees, and delays in utility services.   System Development Fees All fees must be paid for water & sewer connections before meters will be set. Please call the finance department customer service line 247-5816 to coordinate payment of fees.     NOTICE OF COMMENCEMENT State of Florida Tax Folio No. 1703954)000 County of Duval To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved: 16-2S-29E SALTAIR SEC 3 LOTS 73,74,75,76 0/R BKS 1317-593,1377-282, 3472-825,4121-1181,5256-626 Address of property being improved: 760 Sherry Dr,Atlantic Beach,FL 32233 General description of improvements: Complete demolition of single family home Owner: hi: A13 \e.; ;Aitp___ . L.LL Address: -Y3 S CL \Itk. Kew/VIOL W`. Owner's interest in site of the improvement: -T c%e- 5 ^t le.,ag_otiet ( Fee Simple Titleholder(if other than owner): Name: Contractor: Realco Recycling Co Inc Address: 8707 Somers Rd,Jacksovnille,FL 32226 Telephone No.: (904)757-7311 Fax No: (904)751-6611 Surety(if any) Address: Amount of Bond$ Telephone No: Fax No: Name and address of any person making a loan for the construction of the improvements Name: Address: Phone No:Fax No: Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may be served:Name: Address: Telephone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Name: Address: Telephone No: Fax No: DLESPERGER f`Y'•u&c: GG 353178 Expiration date of Notice of Commencement(the expiration date is one(1)year fr, Th.:;ssat}e c r t t lehss iffe i t date is specified): w;• i : o EXPIRES: ctober o,4v. ars I — f-, ,? Bon.-• ' •• . THIS SPACE FOR RECORDER'S USE ONLY OWNER lDoc#202?230363,OR BK?ogo4 cage Eng Signed: • 414L.J 4 • / i 4, Date: 4 - l Number Pages:1 Before me this Z day of - 2-0 G (in the StfDuval, e Recorded 09/02/2021 11:44 AM, Of Florida,has personally appeared:. Y t JODY PHILLIPS CLERK CIRCUIT COURT DUVAL Notary Public at Large,State of Florida, my of Qt yak COUNTY My commission expires: RECORDING $10.00 Personally Known: vt or Produced Identification: BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach,FL 32233 Office(904)247-5826 Fax(904)247-5845 Job Address: 760 Sherry DrdUPermitNutuber. '`Q N.), SFrILOIS ra.l,.nt.mtxa NO,ll/MO.tln412.el]42la1tr-rasn Legal Description Farrel M 170395-0000 rloot Area ol Sq.Ft. Sq.Ft Valuation of Work S 10,000 Proposed Work heated/cooled 1756 non-heated/cooled 2355 lass of Work(circle one). Nets Addition Alteration Repair Mos e)emolitio)pool spa window door 1 Se of existing/proposed structures)(circle one). Commercial 4{ I? If an existing structure,is a fire sprinkler system installed?(Circle one). c' is 4111120 4onda Product Approsat ss For multiple products use product approval Form I)c:.nhe in detail the tt pe of stork to be pertiinned Complete demolition of house structure Pronerts 0%neo Information: 7/ r" ' u'Name p tiv 1 O uI reds J D 5C° /1 C 1VFW° 1b`)tCo% f 1' tattlip -.• oG^ 'fr(v I-Madsir l•a s, t)porno!t _e61, (16A45,;.0(*C0/1 Contra-tor Information: C Compan>Name Realco Recycling Co Inc Qualifying AgencJerty Doherty _ Address:8707omera RW City Jecksonvile State FL Zip 32226 Office Phone 7S7-7311 Job Site Contact Number 555-3581 Fax a 751.6611 State Certification Registration= CGC 055166 Architect Name&Phone_ n/a Engineer's Name R Phone s, n/ a Fee Simple Title Holder Name and Address n/a Bonding Compam Name and Address n/a Mortgage lender Name and Address n/ a i pphwnsn ss hereby made to obtain a prow us di the NON and rnsrallananr as sntcvred l.erne that no ware or rnrlaltanon has commenced poor to rhe rssuartie of a perms and that all work urn he per/brined to meet the standard,if all laws reetsInrre construction in rhra)unsdnirnn TM,permit hemmer null and turd If sort is not commenced m akn six red months.,w it.,nanctum or wort er in,p vuled,b abandoned lira penod at scr r61 months at any once refer ort is cammenaed f understand that separate permits must he,ecvrad for Electrical-Work.numbing.Signs.Melt,Pool,,Ammer,.Bailee,.Heaters,Tams,end Ii,Corediti,mar,.ter. 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 RECORDING YOUR NOTICE OF COMMENCEMENT. I hereby serriii that I hare read and e, red this ryrphrurnon and knowthe sae ro ha nue and so :ill pnnt.s nm u i tans and orsbnuu:es Si wet-nonene thiotypeofwok"nil be complied mot whether specifiedrohereinorroc The some, he grassing of a permit skier not presume re gore mho h'to violate or cartel the ern utter h-Jaid..mare.,r local fins regulanne coeur .run or the p romance of euntrurmon r 1 Signature of Owner l. - u Signature of Ctnnrac PrinttName - f SdM o-(ati Print Name Jorry ohorty Sws)to-and ri,-, r ore me Sworn t and sobscri r before me thi. •C-f)ay • cn • t this Day ' • PRIMP ..F . _WNW-. Nota is / 1 Revised 01.26.10 Ypu'•,, TONI GINDLESPERGER AMY M.GADAPEE MY COMMISSION#GG 353178 Notary Public,State of Florida EXPIRES:October 6,2023 My Comm.Expires 10129!2024 Commission No.HH58644 SFoFf.o•`. Bonded Thru Notary Public Underwriters Prepared By: Gibraltar Title Services, LLC Attn: Kristen Arranz 4190 Belfort Rd., Suite 475 Jacksonville, FL 32216 Return To: Gibraltar Title Services, LLC Attn: David Ubbens 4190 Belfort Rd., Suite 475 Jacksonville, FL 32216 Order No.: GTS-2171162 Property Appraiser's Parcel I.D. (folio) Number: 170395-0000 WARRANTY DEED THIS WARRANTY DEED dated August 27, 2021, by Margaret S. Hopson, an unmarried woman, as to an undivided 1/3 interest, whose post office address is 12022 Stone Crossing Circle, Tampa, Florida 33635-6227 (the "Grantor"), to AF AB Venture, LLC, a Florida limited liability company, whose post office address is 1738 Selva Marina Drive, Atlantic Beach, Florida, 32233-5618 (the "Gra i4 62 L aai Wherever used herein the terms "Grantor" and "Grantee" include all the parties to t I the heirs, legal representatives and assigns of individuals, and the successors and assigns of corporations) WITNESSETH: That the Grantor, for and in consideration of the sum of Ten And No/100 Dollars ($10.00) and other valuable consideration, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys, and confirms unto the Grantee, all that certain land situated in County of Duval, State of Florida, viz: Lots 73, 74, 75 and 76, SALTAIR SECTION NO. 3, a subdivision according to the plat thereof recorded in Plat Book 10, Page 16, of the Public Records of Duval County, Florida. Said property is not the homestead of the Grantor(s) under the laws and constitution of the State of Florida in that neither Grantor(s) or any members of the household of Grantor(s) reside thereon. Subject to easements, restrictions, reservations and limitations of record, if any. TOGETHER with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining. TO HAVE AND TO HOLD the same in Fee Simple forever. AND the Grantor hereby covenants with said Grantee that the Grantor is lawfully seized of said land in fee simple; that the Grantor has good right and lawful authority to sell and convey said land; that the Grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all encumbrances, except taxes accruing subsequent to: December 31, 2020. rS,,,,,,!; ATLANTIC BEACH BUILDING DEPT. t ',DEMOLITION — PROPERTY OWNER s RELEASE FORM s— 8 /30/?Date:3 OP ( To Whom It May Concern: I / We the current property owners of: Lot 73,74,75,76 Block 1317-593,1377-282, 3472-825,4121-1181,5256-626 Legal Description of Property AKA 760 Sherry Dr have contracted with to have Address of Property) Realco Recycling Co Inc to remove the single family home Company Name) Single Family,Duplex,Commercial,etc.) Prior to the construction of : AU 14 As a condition of issuing the permit we agree to the following: 1. All utilities are to be located and clearly marked. 2. Once house is removed, lot is to be graded and leveled. 3. All construction debris is to be removed from the property. 4. Affected area is to have grass or seed in place. 5. Erosion control devices will be put in place and will remain in place until grass has covered affected area or new structure is completed and landscaping is in place. V. G Signature Signature THIS SPACE FOR RECORDER'S USE ONLY OWNER Signed: \ J U ,014:A tI• r( ,fr Dater a 0/Z Before me this 3 O day of Fes( ZO2. i •• ths_Coun of vat,State Of Florida,has personally appeared,' ' f} ,`S , 1-0 fl'Notary Public at Large,State of F irida, L.sunty ofIRR My commission expires: C I Personally Known: l( ,S or Produced Identification: j ..-,‘:,'!:;1k4,'',. TONI GINDLESPERGER M. ; MY COMMISSION#GG 353178 tcri EXPIRES:October 6,2023 il_. of?::°•'' Bonded Thru Notary Public Underwriters A-..., EXHIBIT A. LETTER OF AUTHORIZATION DRTV 10- I Realco Recycling Co Inc is hereby authorized to act on behalf of fidi'5 o,k Es-CS criN the owner(s)of those lands described within the attached application,and as described in the attached deed or other such proof of ownership as may be required by the City of Atlantic Beach in applying for a development permit. BY: V (1A4/141'64/1 A.1_ -r-oniaA-W-N Signature of Owner or Owner's Legal Representative 17 , PI 1" c l 1.) a{''1 L, Printed Name 11 35(p__ f u a a a 741 . 141, UC1( Th Mailing Address Phone Cell Fax mai State of: F ( countyof: u V'( Signed and sworn before me on thi3-- 1"-' day of ` `')S , 2°2 (, by Identification verified: Oath sworn: r Yes r No Q c_Ci(_ Lr-- Notary Signature My Commission expires: s PG •,, TONT GINDLESPERGER IMYCOMMISSION#GG 353178 e EXPIRES:October 6,2023 6 F;° Bonded Thru Notary Public Underwriters EXHIBIT A_Letter of Authorization_vo5.io.io lA ric, TREE & VEGETATION AFFIDAVIT FOR INTERNAL OFFICE USE ONLY I>City of Atlantic Beach PERMIT# Community Development Department 800 Seminole Road Atlantic Beach, FL 32233 on v.P)904-247- 5800 SITE INFORMATION ADDRESS O Skp\A,g_A • SUBDIVISION sol gl C-t BLOCK LOT ;344, RE# }Q q ` zO Q ESIDENTIAL COMMERCIAL j OTHER APPLICANT INFORMATION NAME t /I r5 cnl'1 t • l/-PHONE# q0c/ -3-'4, 37V- ADDRESS 7g ' ADDRESS ( J c2._f is r v l euwinek CELL# CITY /9-0 , /3c,A STATE CODE 5 EMAIL Cfd) S / Clean apl , CCy --\ WNER 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 HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT:Signature of Property Owner(s)or Authorized Agent I' (Ww ( I1),- — V AllfS6 /1 Lt). 1arse 6- / SIGNATURE OF APPLICANT PRINT OR TYPE NAME DATE SIGNATURE OF APPLICANT(2) PRINT OR TYPE NAME DATE Signed and sworn before me on this day of 22_ ( by State of County of 'L)V Q Identification verified: Oath Sworn: Yes Ne TONI GINDLESPERGER ` c MY COMMISSION#GO 353178 Notary Signaturetc)-- ri, 'e EXPIRES:October 6,2023 FpFr?" Bonded'Nu Notary Public Underwriters My Commission expires 04 TREE AND VEGETATION AFFIDAVIT 03.01.2018 MAP SHOWING SURVEY OF LOTS 73, 74, 75 AND 76, SALTAIR SECTION 3, AS RECORDED IN PLAT BOOK 10, PAGE 16, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. I FFaun 1 maN ea 18.PRE,CAP rIR E I IL0T96IL0T7 2 I 100.10' (FIELD) e2>2...,11_ 6'11h700 FENCE '00.00' 4• P .NO CAPS ef._o.o' 4 01419 U N\K FENCE p®AR,121337. 9 CiYMoyX0.6' Oy•g -F. O LOT 7 J 0' . 0v I OS f; 1 — 11NOOD COICREIE 0 LOT 94 . I0 JJ.7' La d• 0-X g CONCRETE ORM LOT 74 c3 El 3 L J' i 1-STORY BRICK .1... N Q' 12 RESIDENCE nt 0 I No. 760 J Cr 2 1 I / w 1II a --9 m LOT 9J OO 20.9' 6 0 0 1A33Ta Iin y 4, I I n I 0.41 2SY7//// 1 Jar l 90.14' F -t2 6 x' FLOOD ZONE'K' l 0 T 7 a 72 FLOOD ZONE'' C4 I L 0 T 9 2 4'OWN 1914 F7 _K x TO-UNE LOT 76r g I ds Q 9O I b,1 •d o3 s,.II T 46' PIPE.192672 f.2' 100.00' SETPIPE.1/r193672 L 0 T 9 1 I LOT 77 g I I NOTES: 1. THIS IS A BOUNDARY SURVEY. 2. INTERIOR ANGLES AS PER FIELD SURVEY. 3. NO BUILDING RESTRICTION ONES PER PLAT. 4. NORTH PROTRACTED FROM PLAT. THIS SURVEY IS CERTIFIED TO: AF AB VENTURE LLC THE PROPERTY DESCRIBED HEREON UES IN FLOOD ZONE 'X' (AREA OF MINIMAL FLOOD HAZARD) AND FLOOD ZONE "A" AS DETERMINED FROM THE FLOOD INSURANCE RATE MAP No. 12031C0409J, REVISED NOVEMBER 2, 2018 FOR DUVAL COUNTY, FLORIDA. J......._. NOT VALID WITHOUT THE SIGNATURE AND 1Li; ami0 41O JASON D. BOATWRIGHT, P.S.M. THE ORIGINAL SEAL OF A FLORIDA SCALE: 1' = 20' FLORIDA UCENSED SURVEYOR and MAPPER No. LS 7292 UCENSED SURVEYOR AND MAPPER.' FLORIDA UCENSED SURVEYING and MAPPING BUSINESS No.LB 3672 CHECKED BY: BOATWRIGHT LAND SURVEYORS INC. DATE: DRAWN BY: Jon r AUGUST 26, 2021 FILE: 2021-1212 1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 241-8550 SHEET l OF 1