HomeMy Public PortalAbout12-0555 BishopDATE ISSUED: 10 -19 -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
STREET CUT
107 EIGHTEENTH ST
DEMERY BISHOP
PO BOX 1020
TYBEE ISLAND, GA 31328
FIRST CITY ENTERPRISES
PO BOX 1016
TYBEE ISLAND GA 31328
P
$ 575.00
$ 0.00
PERMIT #: 120555
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TOTAL BALANCE DUE: $ 575.00
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:
‘,10A,t4p.a) 0,1i;
P. 0. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328
(912) 786 -4573 - FAX (912) 786 -9539
www.cityoftybee.org
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City of Tybee Island
PLANNING AND ZONING
P.O. Box 2749 — 403 Butler Avenue, Tybee Island, Georgia 31328 -2749
(912) 472 -5030 — FAX (912) 786 -9539
APPLICATION FOR INFRASTRUCTURE ALTERATION PERMIT
Property Owner Name Ve.•Me� R:) , g \p tp
Address . C 0 �1
Home Telephone c' \ g.G- -- • \ 1.6k Other Phone
Contractor Name ,c -1 ���� �a LI.� Phone 0. \�
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NOTE: Any alteration to City -owned streets, curbs, water lines, sewer lines, drainage pipes, catch
basins, sidewalks, 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:
Address
1. The City's infrastructure will not be degraded in any way.
2. All necessary safety precautions will be undertaken.
3. The City will inspect the work in process and upon completion.
4. The work will be accomplished to the City's satisfaction.
5. The City shall be held harmless of any liability or damage of any variety.
6. 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:
Description of alteration: 1 (�
Estimated cost: $
crk
Drawing attached with alteration. Attached? )/ E5
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
described alteration in accordance with these provisions.
Signatur
Print Name
Approvals:
Zoning Administrator
Code Enforcement Officer
Water /Sewer
Storm /Drainage
City Manager
Signature
Date \0IV1 \ \��
Date
Fees r1
Permit i / 5
Inspection
Engineering Review
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LIMITS OF
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