HomeMy Public PortalAbout11-0088 QuinneyDATE ISSUED: 02 -25 -2011
WORK DESCRIPTION
WORK LOCATION
OWNER NAME
ADDRESS
CITY, ST, ZIP
PHONE NUMBER
CONTRACTOR NAME
ADDRESS
CITY STATE ZIP
FLOOD ZONE
BUILDING VALUATION
SQUARE FOOTAGE
OCCUPANCY TYPE
TOTAL FEES CHARGED
PROPERTY IDENTIFICATION #
PROJECT VALUATION
CITY OF TYBEE ISLAND
BUILDING PERMIT
STREET CUT
1006 JONES AVE
JUDY QUINNEY
107 GOLDEN OAK DR
GUYTON GA 31312
912 - 657 -6195
EMP PROPERTIES LLC
221 PINK DOGWOOD LN
POOLER GA 31322
P
$ 75.00
$ 0.00
PERMIT #: 110088
TOTAL BALANCE DUE: $ 75.00
It is understood that if this permit is granted the builder will at all times comply with the zoning, subdivision, flood control, building, fire,
soil and sedimentation, wetlands, marshlands protection and shore protection ordinances and codes whether local, state or federal, including
all environmental laws and regulations when applicable, subsequent owners should be informed that any alterations to the property must be
approved by the issuance of another building permit. Permit holder agrees to hold the City of Tybee Island harmless on any construction
covered by this permit.
This permit must be posted in a conspicuous location in the front of building and protected from the weather. If this permit is not posted
work will be stopped. The building contractor will replace curb paving and gutter broken during construction. This permit will be voided
unless work has begun within six months of the date of issuance.
Signature of Building Inspector or Authorized Agent:
a.) Oit
P. 0. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328
(912) 786 -4573 - FAX (912) 786 -9539
wvvvv. cityofty bee.org
Darrell Morgan Construction LLC
1042 Sandhill Road
Guyton, Gaa, 31312
912-772-5112 Phone
912-772-5900 Fax
drnconst2@gmail.com
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Company name: Date Sent 90,
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Phone. Number Of Pages:
Far. (q 11150Z
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DARRELL MORGAN CONSTRUCTION, LLC
1042 Sarni 11111 Road
Guyton, Georg. 31312
912-772-5112 PHONE
912-772-5900 FAX
—LP
STAT OF GEORGIA
Geor gia Secretary of State
State Construction Industry Licensing Board
Utility Contractor
LICENSE NO. UC30192S
Darrell Morgan Construction, LLC
1390 Hwy 215
Springfield GA 31329
EXPIRATION DATE - 04/30/2011
Active
L.
auto.Owners Inset
L.e Hume Ca Bsns
BOND RIDER
(ALL PURPOSE)
To be attached to and form part of Bond No. 66103427
Executed the 16th Day of February, 2011
In The Penal Sum of ($500.)
By EMP Properties LLC As Principal and
The Auto - Owners Insurance Company As Surety,
In Favor of City of Tybee Island As Obligee.
The above mentioned bond covers the aforesaid Principal as Contractor
The aforesaid Principal and Surety hereby agree that:
1, Terns Dates are amended
From: 2 -16 -2011 to 2 -16 -2012
To: 2 -16 -2011 to 2 -16 -2013
rEB2'5201U
BY: ...... ....... .
[py
j5 ;n
SCAA.,
C-1) rod 0,-0.e,
n OZ -1(0-20(3
2. The attached bond shall be subject to all its agreements, limitations and conditions except as
herein expressly modified.
3. This rider shall become effective as of the beginning of the 16th day of February, 2011.
Auto - Owners Insurance Company
B
Karen L. Maddison, Attorney -in -fact
Date Signed and Sealed: February 21, 2011
2959 (7 -10)
DATE AND ATTACH TO ORIGINAL BOND
AUTO - OWNERS INSURANCE COMPANY
LANSING, MICHIGAN
POWER OF ATTORNEY
NO.66103427
KNOW ALL MEN BY THESE PRESENTS: That the AUTO- OWNERS INSURANCE COMPANY AT LANSING, MICHIGAN, a Michigan
Corporation, having its principal office at Lansing; County ofEaton, State of Michigan, adopted the following Resolution by the directors of the Company
on January 27, 1971, to wit:
"RESOLVED, That the President or any Vice President or Secretary or Assistant Secretary of the Company shall have the power and authority
to appoint Attorneys -in -fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and
undertakings, recognizances, contracts of indemnity, and other writings obligatory in the nature thereof. Signatures of officers and seal of Company
imprinted on such powers of attorney by facsimile shall have same force and effect as if manually affixed. Said officers may at any time rento e and
revoke the authority of any such appointee!'
Does hereby constitute and appoint Karen L. Maddison
its true and lawful attorney(s)- in -fact, to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, recognizances,
contracts of indemnity and other writings obligatory in the nature thereof, and the execution of such instrument(s) shall be as binding upon the AUTO -
OW NERS INSURANCE COMPANY AT LANSING, MICHIGAN as fully and amply, to all intents and purposes, as if the saute had been duly executed
and acknowledged by its regularly elected officers at its principal office.
IN WITNESS Wl- IEREOF, the AUTO - OWNERS INSURANCE COMPANY AT LANSING, MICHIGAN, has caused this to be signed by its
authorized officer this 3rd
day of
February , 2011 .
Kenneth R. Schroeder, Senior Vice President
STATE OF MICHIGAN ss.
COUNTY OF EATON
On this 3rd day of February , 2011, before me personally came Kenneth R. Schroeder, to nie known, who being duly sworn, did depose and
say that they are Kenneth R. Schroeder, Senior Vice President of AUTO - OWNERS INSURANCE COMPANY, the corporation described in and which
executed the above instrument, that they know the seal of said corporation, that the seal affixed to said instrument is such Corporate Seal, and that they
received said instrument on behalf of the corporation by authority of their office pursuant to a Resolution of the Board of Directors of said corporation.
My commission expires September 28, 2011
(mss /�6�55r �iC J
Michelle A. Bottum, Notary Public
STATE OF MICHIGAN
COUNTY OF EATON SS.
1, the undersigned First Vice President, Secretary and General Counsel of AUTO- OWNERS INSURANCE COMPANY, do hereby certify that the
authority to issue a power of attorney as outlined in the aboveboard of directors resolution remains in full force and effect as written and has not been aktd
and the resolution as set forth are now in force.
Signed and sealed at Lansing, Michigan. Dated this 3rd day of February , 2011
Stuart R. Birn, First \lice President, Secretary and General Col nsel
This power of attorney is attached to bond number 66103427 , issued to EMP Properties LLC
on February 21 , 20 11
2940 (5 -09)
,iuto- Owners Insurance, Mtd ET
Re172011 u
LICENSE AND PERMIT BOND
BY;
For County, City, Town or Village Only - Not Valid for Bonds Required by the State. Not Valid for Contract, Performance,
Maintenance, Subdivision, Agent to Sell Hunting and Fishing Licenses or Utility Guarantee Bond.
KNOW ALL MEN BY THESE PRESENTS: BOND No. 66103427
That we, EMP PROPERTIES LLC
of the CITY of POOLER , State of GEORGIA , as Principal,
and the Auto - Owners Insurance Company, a Corporation duly licensed to do business in the State of MICHIGAN
as Surety, are held and firmly bound unto the CITY , of TYBEE ISLAND , State
of GEORGIA , Obligee, in the amount of FIVE - HUNDRED
($ 500.00 ) DOLLARS, lawful money of the United States, to be paid to said Obligee, for which payment well and truly to be
made, we bind ourselves and our legal representatives, jointly and severally.
THE CONDITION OF THIS OBLIGATION IS SUCH, That whereas, the Principal has been licensed as a
SEWER TAPPER by the Obligee.
NOW THEREFORE, if the Principal shall faithfully perform the duties and comply with the laws and ordinances (including all
Countersigned
By
4, d p% ; J n this obligation to he void, otherwise to remain in full force ttnd offers for a
`+ r day of FEBRUARY , 2011 ,
j 4'° be day of FEBRUARY 2012 , unless
Resident Agent
qty upon sending notice in writing to the Obligee and to the Principal, in care
tis reasonable, and at the expiration of thirty -five (35) days from the mailing of
7, whichever is later, this bond shall terminate and the Surety shall be relieved
the Principal.
day , F BRUARY 2011
IA MIK J�1
P, incipal
Principal
AUTO - OWNERS INSURANCE COMPANY
Attorney -in -Fact
29383 (1-10)
DATE AND ATTACH TO ORIGINAL BOND
AUTO- OWNERS INSURANCE COMPANY
LANSING, MICHIGAN
POWER OF ATTORNEY
NO.66103427
KNOW ALL MEN BY THESE PRESENTS: That the AUTO - OWNERS INSURANCE COMPANY AT LANSING, MICHIGAN, a Michigan Corporation, having its
principal office at Lansing, County of Eaton, State of Michigan, adopted the following Resolution by the directors of the Company on January 27, 1971, to wit:
"RESOLVED, That the President or any Vice President or Secretary or Assistant Secretary of the Company shall have the power and authority to appoint
Attorneys-in-fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances,
contracts of indemnity, and other writings obligatory in the nature thereof. Signatures of officers and seal of Company imprinted on such powers of attorney by
facsimile shall have same force and effect as if manually affixed. Said officers may at any time remove and revoke the authority of any such appointee."
Does hereby constitute and appoint KAREN L MADDISON
its true and lawful attorney(s) -in- fact,to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, recognizances, contracts
of indemnity and other writings obligatory in the nature thereof, and the execution of such instrument(s) shall be as binding upon the AUTO - OWNERS INSURANCE
COMPANY AT LANSING, MICHIGAN as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly
elected officers at its principal office.
IN WITNESS WHEREOF, the AUTO- OWNERS INSURANCE COMPANY AT LANSING, MICHIGAN, has caused this to be signed by its authorized officer
this 3rd day of February, 2011.
Kenneth R, Schroeder, Senior Vice President
STATE OF MICHIGAN' „.
COUNTY OF EATON J
On this 3rd day of February, 2011, before me personally came Kenneth R. Schroeder, to me known, who being duly sworn, did depose
and say that they are Kenneth R. Schroeder, Senior Vice President of AUTO-OWNERS INSURANCE COMPANY, the corporation
described in and which executed the above instrument, that they know the seal of said corporation, that the seal affixed to said instrument is
such Corporate Seal, and that they received said instrument on behalf of the corporation by authority of their office pursuant to a Resolution
of the Board of Directors of said corporation.
My commission expires September 28, 2011,
Michelle A. Bottum, Notary Public
STATE OF MICHIGAN l ss.
COUNTY OF EATON J
I, the undersigned First Vice President, Secretary and General Counsel of AUTO - OWNERS INSURANCE COMPANY, do hereby certify that the authority to
issue a power of attorney as outlined in the above board of directors resolution remains in full force and effect as written and has not been revoked and the
resolution as set forth are now in force.
Signed and sealed at Lansing, Michigan. Dated this3rd day of February, 2011.
Stuart R. Birn, First Vice President, Secretary and General Counsel
*This power of attorney is attached to bond number 66103427, issued to EMP PROPERTIES LLC on February 16, 2011.
2940 (05 -09) GA Print Date: 02/16/2011 Print Time: 12:28:27
Name
'11,(X'1`.
City of Tybee Island
COMMUNITY DEVELOPMENT DEPARTMENT
P.O. Box 2749 – 403 Butler Avenue, Tybee Island, Georgia 31328 -2749
(912) 786 -4573 – FAX (912) 786-9539
APPLICATION FOR INFRASTRUCTURE ALTERATION PERMIT
PIA-i 41()LN cz.c_ / CM?
Address 10 3 (. 4-3(te 1 ) - JP
Home Telephone ? '
Other Phone
NOTE: Any alteration to City -owned streets, curbs, sidewalks, water lines, sewer lines, drainage
pipes, catch basins, or other elements of the City's infrastructure, requires a permit from the City,
and an acknowledgement by the individual seeking to accomplish the alteration, that:
a. The City's infrastructure will not be degraded in any way.
b. All necessary safety precautions will be undertaken.
c. The City will inspect the work in process and upon completion.
d. The work will be accomplished to the City's satisfaction.
e. The City shall be held harmless of any liability or damage of any variety.
f. The individual has read applicable portions of the City's Code of Ordinances dealing
with the alteration, and agrees to fully comply with such provisions.
Location of work: it) 0
Description of alteration:
i1 S - -
a- i2 u' ev11e
Estimated cost of construction: $
A sketch or drawing must be attached illustrating the planned alteration. Attached?
City Design Standards and Specifications: Any alteration to the City's infrastructure shall be
accomplished in such a fashion so as to restore the infrastructure to essentially the same
condition that existed prior to the alteration, or to an improved condition, as determined by the
City.
Certification: I hereby acknowledge the above requirements, and certify that I will perform the
above describ 'alteration i 1 apeordance with these provisions.
/a-
Signature f ; Date 3l
1
Approvals:
Zoning Administrator
Code Enforcement Officer
Water /Sewer
Storm /Drainage
City Manager
Date
glsbi
Fees
Permit '7
Inspection
Engineering Review
TOTAL
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