HomeMy Public PortalAbout12-0231 SmithDATE ISSUED: 04 -18 -2012
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
RESIDENTIAL DOCK
156 S CAMPBELL AVE
T. STUART SMITH
480 EATONTON HWY
GRAY GA 31032
T. STUART SMITH
480 EATONTON HWY
GRAY GA 31032
P
$ 105.00
$2,000.00
PERMIT #: 120231
No work allowed
by boat or barge
and no heavy
equipment
allowed on shore.
TOTAL BALANCE DUE: $ 105.00
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:
ci—)4 ,J0/16.-
9 n, ? l ,V-1 -e , C L ose
P. 0. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328
(912) 786 -4573 - FAX (912) 786 -9539
www.cityoftybee.org
1-1-O23 I
CITY OF TYBEE ISLAND, GEORGIA
APPLICATION FOR BUILDING PERMIT
Location: /5- 0 SDU 4J) #
NAME
ADDRESS
TEL PH ON
Owner
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viol ' tR..
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Architect
or Engineer
Building
Contractor
(Check all that apply)
❑ Repair
❑ Renovation
R ✓Minor Addition
❑ Substantial Addition
❑ Other
R
Details of Project: i Ct tt-Q
e___3, \S n,3
Estimated Cost of Construction: $
C . nstruction Type
(1) Wood Frame
(2) ood & Masonry
(3) Bri. Veneer
Propose. se:
Remarks:
ATTACH A
following in
# Units
Lot Ar
# Off- treet parking sp. es
Tree • located & listed on ite plan
Ac • ss:
Residential
Single Family
Duplex
Multi- Family
Commercial
❑ Footprint Changes
❑ Discovery
❑ Demolition
6 ►'1 G d b : k� lr 2oGt t
J
C , C._(-.
,o■ aa�
(Enter appropriate number)
(4) Masonry
(5) Steel & Masonry
(6) Other (please specify)
PY OF THE CERTIFIED ELEVATION SURVEY OF LOT and complete the
ation based on the construction drawings and site plan:
Dr eway
S tbacks: Front
(ft.)
Stories Height
grade of the building to the extrem
units, ventilation ducts, air condition
# Bedrooms # Bathrooms
Living space (total sq. ft.)
With culvert?
Rear
With Swale?
Sides (L) (R)
Vertical distance measured from the average adjacent ,
high point of the building, exclusive of chimneys, heating
g units, elevators, and similar appurtances.
During construction:
On -site restroom facilities will be provided through
On -site waste and debris containers will be provided by
Construction debris will be disposed by by means of
I understand that I must comply with zoning, flood damage control, building, fire, shore
protections and wetlands ordinances, FEMA regulations and all applicable codes and regulations.
I understand that the lot must be staked out and that the stakes will be inspected to ensure that the
setback requirements are met. I understand also that a certified plot plan showing elevation must
be attached to this application and that an as -built elevation certification is due as soon as the
habitable floor level is established. Drainage: I realize that I must ensure the adequacy of
drainage of this property so that surrounding property is in no way adversely affected. I accept
responsibility for any corrective action that may be necessary to restore drainage impaired by this
permitted construction.
Date: Signature of Applicant:
Note: A permit normally takes 7 to 10 days to process.
The following is to be completed by City personnel:
Zoning certification NFIP Flood Zone
Approved rezoning/variance?
Street address and number: New Existing
Is it in compliance with City map?
If not, has street name and/or number been reported to MPC?
FEMA Certification attached
State Energy Code Affidavit attached
Utilities and Public Works:
Describe any unusual finding(s)
Access to building site
Distance to water main tap site
Distance to sewer stub site
Water meter size
Storm drainage
Approvals: Signature Date
Zoning Administrator
Code Enforcement Officer
Water /Sewer
Storm/Drainage
Inspections
City Manager
FEES
Permit
Inspections
Water Tap
Sewer Stub
Aid to Const.
TOTAL
LEAD -BASED PAINT
Adapted from http: / /www.epa.4ov/lead /pubs /renovation.htm. Please use that site to access the following information.
Information for Property Owners of Rental Housing, Child- Occupied Facilities
Property owners who renovate, repair, or prepare surfaces for painting in pre -1978 rental housing or space
rented by child -care facilities must, before beginning work, provide tenants with a copy of EPA's lead hazard
information pamphlet Renovate Right: Important Lead Hazard Information for Families Child Care Providers,
and Schools. Owners of these rental properties must document compliance with this requirement. EPA's sample
pre- renovation disclosure form may be used for this purpose.
After April 22, 2010, property owners who perform these projects in pre -1978 rental housing or space rented
by child -care facilities must be certified and follow the lead -safe work practices required by EPA's Renovation,
Repair and Remodeling rule. To become certified, property owners must submit an application for firm
certification and fee payment to EPA. The Agency has up to 90 days after receiving a complete request for
certification to approve or disapprove the application.
Property owners who perform renovation, repairs, and painting jobs in rental property should also:
• Take training to learn how to perform lead -safe work practices.
• Learn the lead laws that apply regarding certification and lead -safe work practices beginning in April 2010.
• Keep records to demonstrate that you and your workers have been trained in lead -safe work practices and that you followed lead -
safe work practices on the job. To make recordkeeping easier, you may use the sample recordkeepinq checklist that EPA has
developed to help contractors comply with the renovation recordkeeping requirements that took effect April 2010.
• Read about how to comply with EPA's rule in the EPA Small Entity Compliance Guide to Renovate Right.
• Read about how to use lead -safe work practices in EPA's Steps to Lead Safe Renovation, Repair and Painting.
Information for Homeowners Working at Home
If you are a homeowner performing renovation, repair, or painting work in your own home, EPA's RRP rule does not cover your project.
However, you have the ultimate responsibility for the safety of your family or children in your care. If you are living in a pre -1978 home
and planning to do painting or repairs, please read a copy of EPA's Renovate Right: Important Lead Hazard Information for Families, Child
Care Providers, and Schools lead hazard information pamphlet. You may also want to call the National Lead Information Center at 1 -800-
424 -LEAD (5323) and ask for more information on how to work safely in a home with lead -based paint.
Information for Tenants and Families of Children under Age 6 in Child Care Facilities and Schools
As a tenant or a parent or guardian of children in a child care facility or school, you should know your rights when a renovation job is
performed in your home, or in the child care facility or school that your child attends.
• Before starting a renovation in residential buildings built before 1978, the contractor or property owner is required to have tenants
sign a pre- renovation disclosure form, which indicates that the tenant received the Renovate Right lead hazard information
pamphlet.
Beginning in December 2008, the contractor must also make renovation information available to the parents or guardians of
children under age six that attend child care facilities and schools, and to provide to owners and administrators of pre -1978 child
care facilities and schools to be renovated a copy of EPA's Renovate Right: Important Lead Hazard Information for Families, Child
Care Providers, and Schools lead hazard information pamphlet.
Information for Contractors
As a contractor, you play an important role in helping to prevent lead exposure. Ordinary renovation and maintenance activities can create
dust that contains lead. By following the lead -safe work practices, you can prevent lead hazards. Contractors who perform renovation,
repairs, and painting jobs in pre -1978 housing and child- occupied facilities must, before beginning work, provide owners, tenants, and
child -care facilities with a copy of EPA's lead hazard information pamphlet Renovate Right: Important Lead Hazard Information for Families,
Child Care Providers, and Schools. Contractors must document compliance with this requirement. EPA's pre- renovation disclosure form may
be used for this purpose. Understand that after April 22, 2010, federal law will require you to be certified and to use lead -safe work
practices. To become certified, renovation contractors must submit an application and fee payment to EPA. See: Application for firm
certification. The Agency has up to 90 days after receiving a complete request for certification to approve or disapprove the application.
Contractors who perform renovation, repairs, and painting jobs should also:
• Take training to learn how to perform lead -safe work practices.
• Find a training provider that has been accredited by EPA to provide training for renovators under EPA's Renovation, Repair,
and Painting (RRP) Program. Please note that if you previously completed an eligible renovation training course you may
take the 4 -hour refresher course instead of the 8 -hour initial course from an accredited training provider to become a
certified renovator. Click here for a list of eligible courses.
• Provide a copy of your EPA or state lead training certificate to your client.
• Tell your client what lead -safe methods you will use to perform the job.
• Learn the lead laws that apply to you regarding certification and lead -safe work practices beginning in April 2010.
• Ask your client to share the results of any previously conducted lead tests.
• Provide your client with references from at least three recent jobs involving homes built before 1978.
• Keep records to demonstrate that you and your workers have been trained in lead -safe work practices and that you followed lead -
safe work practices on the job. To make recordkeeping easier, you may use the sample recordkeepinq checklist that EPA has
developed to help contractors comply with the renovation recordkeeping requirements.
• Read about how to comply with EPA's rule in the EPA Small Entity Compliance Guide to Renovate Right.
• Read about how to use lead -safe work practices in EPA's Steps to Lead Safe Renovation, Repair and Painting.
IF YOU'RE NOT
LEAD SA%E (FRTIIED
.DISTURBING
JUST SIX
SQUARE FEET
'COULD COST YOU
.BIG TIME:
Signature Date
Printed Name
DIFT.OF
IILIOUPWAII
GEORGIA
Permit Acknowledgement of
Asbestos /Environmental Notification to Georgia EPD for
Projects Involving Demolition, Wrecking, or Renovation
The undersigned hereby acknowledges that the issuance of this permit does not in any way grant
permission to the owner, owner's representative, or permit holder to proceed with demolition,
wrecking, or renovation of a structure prior to the filing of any required ten (10) day "Project
Notification for Asbestos Renovation Encapsulation or Demolition" form in accordance with
the Georgia Asbestos Rules. The Georgia Environmental Protection Division administers the
rules. In most cases, the rules require both the owner and the involved contractors to assure the
portion of the building involved in the project is thoroughly inspected by an Accredited Asbestos
Inspector for materials that contain asbestos; and the removal of the asbestos before renovation,
wrecking, or demolition begins almost without exemption. Georgia EPD requires a completed
demolition notification from be submitted 10 workings days in advance even if no asbestos is
present in the building. Further guidance for regulatory compliance and contact telephone
numbers are provided by the brochures entitled Asbestos & Renovation and Asbestos and
Demolition. Other environmental issues such as asbestos removal techniques, lead abatement,
ground contamination, or unusual site conditions may have EPD regulations that could affect the
project.
Undersigned
Printed Name
Date
Office Use Only:
Project Address:
Permit Number:
MAR 2 3 2012
MARK WILLIAMS
COMMISSIONER
Stuart Smith
480 Eatonton Hwy
Gray, GA 31232
`,�GENORGIA
COASTAL RESOURCES DIVISION
A.G. "SPUD" WOODWARD
DIRECTOR
RE: Revocable License - Construction of a Private Residence Dock Facility, Horse Pen Creek, Chatham
County, Georgia (GPS- 32.009845 °N /- 80.851730 °W)
Dear Mr. Smith:
In response to your application for a Department of the Army Programmatic General Permit PGP0083
(960009050) for a private, single - family residence, recreational dock facility, please find enclosed a
fully executed Revocable License for the construction and maintenance of a private, single - family
residence, recreational dock facility. This license serves as authorization to utilize state -owned tidal
water bottoms for your dock facility as per the location, dimensions, and configuration depicted in your
application for such license.
Your facility will consist of a 5' x 152' walkway to a 12' x 14' fixed deck with a 3' x 20' ramp to al0'
x 12' floating dock and a 5'8" x 9' floating boat ramp. The dock will be constructed approximately
10'6" from the extended property line to the left and approximately 58' from the extended property line
to the right of the structure. The entire project extends approximately 13' into the waterway at a point
where the waterway is approximately 53' wide from marsh grass to marsh grass. The dock will be
constructed in a deep water hole so it will not rest on mud at low tide. There is no cover proposed for
this facility.
Any change in the use, location, dimensions, or configuration of the approved facility, without prior
notification and approval from this office, could result in the revocation of this license and in required
removal of the facility. Based on the information and plans submitted with your application, it has been
determined that the dock facility, if constructed as proposed, will comply with the terms and
requirements outlined in the PGP0083.
No construction materials or debris may be placed, disposed of, or stored in jurisdictional areas.
Any incidental impacts associated with this project must be rectified by fully restoring areas to their
pre- construction topographic and vegetative states.
All activities performed under this permit must meet the conditions stated in the enclosed copy of the
PGP0083. This dock facility must be constructed precisely to the approved location, dimension, and
con f guration as depicted in the drawinjs and description provided. If dock corridors exist, please
ensure that this dock facility is constructed in such a fashion that the entire structure fits between the
extended property lines. The facility, for which these authorizations are issued, shall not be used at any
time for business or commercial purposes. Prohibited uses include, but are not limited to, liveaboards,
leasing of the permitted dock space; docking a commercial fishing vessel of any type; and utilization of
the dock facility in any tour or charter boat fishing activities. Pursuant to the Official Code of Georgia
Annotated § 12 -5- 295(7), the structure for which this permit is issued is intended for the single parcel as
was depicted in t8NEuaoNSERVRI`11C�N 1N tvids.saId0 � y ly1 te, single family
912.264.7218 I FAX 912.262.3143 I WWW.COASTALGADNR.ORG
Smith Dock
MAR 232012
Page 2
recreational use. Deviation from this use, including by dual and multi - family or community use, will
result in the immediate revocation of the license and in required removal of the entire facility from state -
owned property, and possible criminal and civil penalties as provided by law. This agreement is not
transferable with ownership interest in the upland property. These authorizations do not relieve you
from obtaining any other required federal, state, or local permits. You must obtain a county or
municipal building permit prior to beginning construction of the dock facility.
The tidal water bottoms and marshlands of coastal Georgia are public trust lands controlled by the state,
except over such lands where a validated Crown or State Grant exists. This license authorizes use of
lands assumed to be under the control of the state. You may proceed with construction of this project
with the knowledge and understanding that this license agreement could be rendered invalid should
another person produce a validated Crown Grant or State Grant.
Please contact Karl Burgess at 912 - 264 -7218 should you require more information.
Sincerely,
Brad Gane
Chief of Ecological Services
Enclosure
Cc: U.S. Army COE- PGP0083
Local County Building Inspector
File # 022712.1045am
APPLICANTS NAME(S):
MAILING ADDRESS:
STATE OF GEORGIA
3 -YEAR REVOCABLE LICENSE REQUEST
ir\r\
(Street) II (City) (Sta (Zip) I ) J I l
PROJECT ADDRESS/LOCATION: (\'p / fL0 C) L - Lt I ) v,
COUNTY: C _h �l'- Y111 WATERWAY: -` r5 ,p JL 4r "t e LATE:
LOT, BLOCK & SUBDIVISION NAME FROM DEED: L r s .. - (x r\. rv\ �� k
". r6 Y LkiGt,Y` ` �. (7` h c� . , C-)A A
A. G. "Spud" Woodward, DIRECTOR
Georgia Department of Natural Resources
Coastal Resources Division
One Conservation Way
Brunswick, Georgia 31520 -8687
Dear Mr. Woodward:
I am making application for a permit with the U.S. Department of the Army, Corps of Engineers, Savannah District. I
understand that the issuance of such a permit will not relieve me of the obligation to obtain authorization from the State of Georgia
since the proposed project would constitute an encroachment on the beds of tidewaters which are State -owned property. Accordingly,
I hereby request that I be granted a revocable license from the State of Georgia. Attached hereto and made a part of this request is a
copy of the plans and description of the project that will be the subject of such a license. I certify that all information submitted is true
and correct to the best of my knowledge and understand that willful misrepresentation or falsification is punishable by law.
I understand that if permission from the State is granted, it will be a revocable license and will not constitute a license coupled
with an interest. I acknowledge that this revocable license does not resolve any actual or potential disputes regarding the ownership of,
or rights in, or over the property upon which the subject project is proposed, and shall not be construed as recognizing or denying any
such rights or interests. I further acknowledge that such a license would relate only to the property interests of the State and would not
obviate the necessity of obtaining any other State license, permit or authorization required by State law. I recognize that I waive my
right of expectation of privacy and I do not have the permission of the State of Georgia to proceed with such project until the
Commissioner of DNR has signed a copy of this request
_ Sincerely,
By: L�
+ (Applicant), it), t' ale if app able
By: ,.]rk
•
( •plicant), title if appl"c
Attachment * * * * * * ** * * * * * * * * * * ** * *** * * * * * * * ** * * * * * *s * **
The State of Georgia hereby grants you a revocable license not coupled with an interest as provided in your request. This area may
now or in the future be utilized by boats employing power drawn nets under the provisions for commercial or sport bait shrimping. In
its occupancy and use of the premises, licensee shall not discriminate against any person on the basis of race, gender, color, national
origin, religion, age, or disability. This covenant by licensee may be enforced by termination of this license, by injunction, and by any
other remedy available at law to the Department. The project proposed for this license must be completed within 3 years of the date of
issuance of the license and must be maintained in serviceable condition. Otherwise, action will be initiated to revoke this license and
all structure must be removed immediately at the licensee's expense.
STATE OF GEORGIA
Office of the Governor
n
For: Mark Williams, Commissioner -DN 4AR 2 3 2012
DATE:
By:
RECEIVED
MAR 15 [a12
Revised 1210
GA DNR / H/2Hu/1\42($
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