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HomeMy Public PortalAbout07-0030 Cupp 11 � CITY OF TYBEE ISLAND BUILDING PERMIT DATE ISSUED: 01-23-2007 PERMIT#: 070030 WORK DESCRIPTION: RESIDENTIAL DOCK WORK LOCATION: 129A LEWIS AVE OWNER NAME CYNTHIA CUPP ADDRESS 129 LEWIS AVE CITY,ST,ZIP TYBEE ISLAND GA 313289791 CONTRACTOR NAME SOLOMON'S TREE SER&DOCK WORK ADDRESS PO BOX 13 CITY STATE ZIP TYBEE ISLAND GA 31328 FLOOD ZONE • BUILDING VALUATION SQUARE FOOTAGE OCCUPANCY TYPE P TOTAL FEE'S CHARGED $ 83.00 PROPERTY IDENTIFICATION# PROJECT VALUATION $8,500.00 TOTAL BALANCE DUE: $ 83.00 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: Ott3 P.O.Box 2749-403 Butler Avenue,Tybee Island,Georgia 31328 (912)786-4573-FAX(912)786-5737 www.cityoftybee.org I . ',:•:., '''''-f4. ■,`);: i-3.P, _,...e, • 1-:,-, ,;."... •.:' 7 I i ' 'A.' •`,..3 •-.;% <-.:' ill Inspection Report City of Tybee Island 403 Butler Avenue P.O. Box 2149 . Tybee !stand, GA 31328 PbonP: (912) 786-4573 e I ) xtension 114 0 NIX: (912) 786-9539 --:/r r- 0 Permit No. 0'7 — 030 Date Requested 1 ri Owner's N BM,o, l_._ Ct_,0 - Date Needed 77-)sre- --21 ,/-5,, "Z 0 0 ?- --- / Z7 Gen. co ntrall fit r (-4-)/N-716 J 5+111)COntrartOr Cot-It:act Nes..nber Location ,.. 61 Z-ez,c))-.3 /G.Te,_ 1 inspector j_71a_ Date of inspection Type of Inspection i - iiVe7: / 4(e- I--)DC Pass Zi-)LL ( I orr - - Fa.. 0 , , 1 1 Yee d .77t./S . D2 CITY OF TYBEE ISLAND, GEORGIA 130)1.I APPLICATION FOR BUILDING PERM CON /T ie 4$ Location: J .P1 9 L ex/91 S e-, PIN# NAME // ADDRESS TELEPHONE Owner &tidy 1)q LecO f _ —Architect r �Lf efq DO 23 or Engineer Building Contractor S loves a-GP 3— VI S (Check all that apply) ❑ Repair ❑ Residential ❑ Footprint Changes ❑ Renovation ❑ Single Family ❑ Discovery ❑ Minor Addition ❑ Duplex ❑ Demolition ❑ Substantial Addition ❑ Multi-Family ❑ Other ❑ Commercial Details of Project: EXAe,tr1 C{ ch7 ck 1 n ) d o cg Estimated Cost of Construction: $ 1 / c..5 a() ° Construction Type (Enter appropriate number) (1) Wood Frame (4) Masonry (6) Other(please specify) (2) Wood&Masonry (5) Steel &Masonry (3) Brick Veneer Proposed use: Remarks: ATTACH A COPY OF THE CER I ELEVATION SURVEY OF LOT and complete the following information bas-• e cons II 'on drawings and site plan: #Units # .edroo • #Bathrooms Lot Area ,vi : s e.«- (total sq. ft.) #Off-street parking .paces i1 Trees located &list:a on s' a 1 a A Access: V Driveway '.) ith c Avert? With swale? Setbacks: Front R--. Sides (L) (R) # Stories Height Vertical distance measured from the average adjacent grade of the building to the extreme high point of the building, exclusive of chimneys, heating units,ventilation ducts, air conditioning 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 Stir 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: 1p 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 6-X/5 ii) 9 Water meter size Storm drainage Approvals: Signature Date FEES Zoning Administrator Permit $7 Code Enforcement Officer Inspections ;Z Ip. Water/Sewer Water Tap Storm/Drainage Sewer Stub Inspections • • • Aid to Const. City Manager TOTAL g3 . FOR I Coastal Resources Division AUG 1 1 2006 Cynthia M. Cupp 129 Lewis Avenue Tybee Island, GA 31328 RE: Revocable License - Construction of a Private Residence Dock Facility, Horse Pen Creek, Chatham County, Georgia (GPS-32.921246°N180.8483778°W) Dear Ms. Cupp: 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 proposed structure will consist of 6' x 74' walkway to a 14' x 6' "T" fixed deck. The existing dock is to be removed prior to construction. The dock will be constructed approximately 42' from the extended property line to the left and approximately 35' from the extended property line to the right of the structure. No portion of the facility will extend into the water as the waterway is dry in this area at low tide and is approximately 20' from marsh grass to marsh grass. 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 proposed dock facility complies with the terms and requirements outlined in the PGP0083. 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 configuration as depicted in the drawings 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,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. The use of this facility for other than private,single • family residence, recreational purposes 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 Georgia Department of Natural Resources • Coastal Resources Division !l__ �-__.__.___t_.._ TAT___ � T)..._.___._•_l. /�___._ _ 1•t 1-'1!1 Cu dock AG 11 2006 Page 2 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 assnnmed 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 the undersigned should you require more information. Sincerely, Brad Gane Assistant Director Ecological Services Section Enclosure Cc: U.S. Army COE-PGP0083 Local County Building Inspector ,9/ .-..„/2, r-i,--i ,-----r---- I 1 . , Ls....y — • 1 , 1 1:\ 1,\ 1 v 1 .,..,,r.01, 11..,... 1... •1 'S / , ,.,.,.,,t i ;•-.J VI r7..f."(..■cc...1 "1-'1 — '-' I.:14.,■–,',-..)id-A40/r 7 . 1....,A4....c 1 . f 'I77 6"27 I r...,.. — 1 I ^.„1 . Z?, iol \ -rir \14-'or4 ••,',..'.{+-r '''5' —.+1,. 1 1 1 1 ,--7---,,--------41 -1.- 1 L 1 1 ,F_______ 1,h r, 1.-- 11, I I / r■ ; i.,,,,,C, )' r.l'Ij — AlkL, ••,,I.A 7\ q ,' ^A% t■ „,-,Q ,- ' '''' /V" 0( ' / 4.`.. • . ,c,! -i i. ..,,,r , .-"".., --.... - ( : • ., :.), ,.,.,,. , 1 1 ! q\s ........ .. . ,, N. \ I \\,s,k----Ic •,..„..., . I .' N.j 9601J1R.1. lfli:F I ! ! ; • .- i 5 ic.0(„_,Id • 'r-----1 , ..,.... L G�je _ r.- -- 1V � I STATE OF GEORGIA REVOCABLE LICENSE REQUEST In Association with a DNR Permitted Project .APPL1CANTS NAME(S):____._t 1? __ _/_+!_ 4, J_ -_'--6ip 1 crmiC> :�Dl)1tE:Sy: 1 act L (.,t f .-_._l-Y.�_.._ -. bee - 1 1. ( !. 3L3 (Stre�ett)) (Cite) (State) trip) • COUNTY: it �� F� WATERWAY: 1 /_.'Cp e,.4DATE:: j61 ,/I 7;1:•UR Shipman.i JSrecior l;corgi-a Department of Natural Resource. Ecological Services Branch One Conservation Way 13runswick,Georgia 31520-8687 Dear Ms.Shipman: 1 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 a uuhl constitute an encroachment on the beds of tidewaters which are State-owned property. Accordingly.,hereby request that I be granted a revocable license front the State of Georgia. Attached hereto and made a part ofthis request is a copy of the plans and description of the project which will be the subject of such a license. I understand that if permission front the State is(granted,it will be a revocable license and will not constitute a license coupled with an . interest. 1 thriller 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 a copy of this request has been signed by Commissioner Holcomb. Sincerely, By: `A/► /1,pplicant),title il'applieable Bv: (Applicant),title if applicable Attachment 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 us 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. Otherwise.action or ill be initialed to revoke the license. S")'ATE OF(.GEORGIA OItice of the Governor 1 13` '' — 4`14 — For: N,bcl Holcomb I Commissioner-DNR DATE: I /I ) 0(1? r i - e If _ e •,, ..... A9 . STATE OF GEORGIA REVOCABLE LICENSE REQUEST In Association with a DNR Permitted Project .APPLICANTS NAME(S):_ d _ ._I_C 1. 4,..,_ A4 1 Permit# ADDRESS: r L _s..._!.7-v�_,.- T... '�F- ��i.,7 ._ j P (Street) (City) / (State) ,y� (Zip) COUNT'S': !( ) � ��d --WATERWAY: '�h_e .e/j DATE:___( "_'f f ! .eau Shipman.Director Georgia Department of Natural Resources . Ecological Services Branch One Conservation Way Brunswick.Georgia;1520-3687 Dear Ms.Shipman: I am making application for a permit with the U.S.Department oldie 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 arc State-owned property. Accordingly,!hereby request that I be granted a revocable license front the State ofGeorgia. Attached hereto and made a part of this request is a copy of the plans and description of the project which will be the subject ot'such a license. 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 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 a copy of this request has been signed by Commissioner Holcomb. • Sincerely, t Bye 5naLtZa-, =./4-- pplicant),title if applicable By: — — — _ — - - (Applicant),title if applicable Attachment ****************************************** 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.Iicensee 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. Otherwise.action will be initiated to revoke the license. STATE OF GEORGIA Office of the Governor 13w: . = 7 ' For: Noel Holcomb Commissioner-DNR DATE: _- F;_1.1._�_P G' kt,“:,,.a_.ts: E0'd :S6 17822 LEE ZT6 ST:.91 90Cit- -JCI Va,C6J,Cf.. L,9 s__ r- r e_ r ` o 'tf� creep. DOCK Noma 1 a er\ Cr . K .,,./ 44, ----tG N $I°OE 39•� N 43°37'28"E 81.68' -- — —• '_ 1/2"RH' ; r-. P r F' I TOl' OF BLUFF . w I i i El U I 1.-E N x d z I LOT 22 �,ta an S rr4 �Q.I p m h 6 i 1 V o J I O ` ' a 41,6° I FT1 3.3 W 1 111 o W o] co" I I 1 aD at loo T zs N I 1 STORY I I P s I RESID2NC£ 1 I co 41.0' p i ; � 1 pd �rwr�Tce I 9 Ft- 1 l a.l LEC.t.71.S 4Y I I, IAI Z , I N I F I - z . ltz• CLOP , I ' I tv S 44'l3'41"W 2 "' i I .. 120.75' J.3J Lek,' / -ve. 90.98' R=3849.72' I I 6" . CR=S 4,9°01'41"WF 1l4r,EiLlrs.JR .&tr�� 90.97' 582'70 HWY HO iflkSe // r*, O`- LEWIS AVENUE 60' R/W Pizefk, Ari`.2oria. 85o)ry PLAT OF LOT 22 & THE NORTHERN HALF . OF LOT 21, PAIN TERRACE, HAMMOCK WARD TYBEE ISLAND CHATHAM COUNTY , , , GEORGIA REVISED FEBRUARY 13, 2006 TO SHOW 15' DRAINAGE STREET ADDRESS: 129 LEWIS AVENUE EASEMENT FOR RELOCATION OF STORM DRAINAGE PIPE, FOR: CYNTHIA M. CUPP ACCORDING TO THE F,LR.M. DATED EQUIPMENT 5/17/86 THIS SITE IS WITHIN FLOOD ALOSU ZONE A8, B 12. ERROR OF CLOSURE: G•ORG./4"N LINEAR: 1/75,400 ANG: 5"/ANGLE /"* ,�15T''-� ,, BALANCED BY: L S. J. WHITLEY REYNOLDS , U PLAT: 1/79,300 LAND SURVEYOR 1 R O. .- 9 a O 20 638 STE sl AOC AVENUE 1 f... ° a t 1" zO' I SCALE: 1 SAVANNAH GEORGIA 31405' 6 DATE: SEPTEMBER 3, 2004 SURVEY TFT•1 PT oid : B12-352-048 � �'/1.)`b� DATE SEPTEMBER 8. 2004 PLAT L FAX: 912-352-7787 FILE NO. 04-188 z -d .013EE-LZ6-2IG ddn0 RpuI3 d6S :E0 90 52 ° U Dec 26 06 03: 59p Cindy Cupp 912-927-3384 p. 1 ge- g 2— -rird t-,D j_D \v-7 14/ ny) r , • d,t,/y2Ls Fsb ) g j643 .--- 4_0-4-09E "D 1, ft, fFC F-2 1F‘:15 912 927 T7R4 96% P.01 '..'11. r '• r...1. •e•-• •. _ ■ _r. lilii 77'7" . , . 1 � N r 1 . :l l• ,", :,,,,(,,,,rti,' : ,,,,. . �. ��` , ., __ • f._ 1 t ti ..• .�) g Vr ,f •y.r.fin.:'• t .. . , , .. ,,,, , , • I i, ...,„„.„ ,. „,,, .,.„ ,, ,. . „, . Iil i , 11111111 �a . ,, . , , i ._ le `�. µ ` �f ..+N a ems_ 0+ l , �', 1 F-- • ® . : G:;,4, y ,- ,,, \ 4 .. . ., . C( ac ord:PC2 ce S ECT1 C Ai 4 ORDINANCE NO. ,2006 AN ORDINANCE TO AMEND THE CODE OF ORDINANCES CITY OF TYBEE ISLAND An ordinance to amend the Code of Ordinance for the City of Tybee Island, Georgia, relating to the regulation of contractors engaged in the construction of dock structures or facilities so as to impose requirements thereon and to provide for bonding and/or insurance as to such contractors; to provide for permits to the extent appropriate; to provide for an effective date, to provide for related matters; to provide for severability; to provide for the repeal of conflicting laws; and for other purposes connected therewith. WHEREAS the duly elected governing authority for the City of Tybee Island, Georgia, is authorized under Article 9, Section 2, paragraph 3 of the Constitution of the State of Georgia to adopt reasonable ordinances to protect and improve the public health, safety, welfare and aesthetics for the citizens of the City of Tybee Island; and WHEREAS the duly elected governing authority of the City of Tybee Island is the Mayor and Council thereof; and WHEREAS, those in the field of constructing docks and structures over the water ways of the state are uniquely susceptible to creating damage to the ecosystem and environment in general as a result of the equipment used in environmentally sensitive, vital areas of the state; IT IS HEREBY ORDAINED by the governing authority of the City of Tybee Island, Georgia, duly assembled that the Code of Ordinances, Section is hereby amended so as to provide as follows: SECTION ONE As used herein the term "Dockbuilder" means any person engaged in the business of constructing, altering, repairing, dismantling or demolishing structures, docks, bridges, fixed or GJ common/emb/14/14536/ordinances/2006/dock builders COMMERr'4L LINES COMMON POLICY --`ECLARATIONS * D[ * INSURANCE IS PROVIDED BY THE COMPANY DESIGNATED BY AN"X": Stock Ul X PENN-AMERICA INSURANCE COMPANY Company * Group * PENN-STAR INSURANCE COMPANY State Control Number * Hatboro, Pennsylvania 19040 PAC6532380 _ _1 Renewal of Number POLICY NUMBER:PAC6628404 1. NAMED INSURED: SOLOMON LANDSCAPING&TREE SERVICE DBA: THOMAS EDWIN SOLOMON MAILING ADDRESS: P.O. BOX 13 TYBEE ISLAND GA 31328 2. POLICY PERIOD: From 10/02/2006 To 10/02/2007 at 12:01 A.M. Standard Time at your mailing address shown above. 3. FORM OF BUSINESS: INDIVIDUAL OTHER DESC: 4. BUSINESS DESCRIPTION: LANDSCAPER IN RETURN FOR THE PAYMENT OF THE PREMIUM,AND SUBJECT TO ALL THE TERMS OF THIS POLICY WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. 5 THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. PREMIUM Commercial General Liability Coverage Part $ 710 . 00 THIS CONTRACT IS REGISTERED Commercial Property Coverage Part $ NOT COVERED AND DELIVERED AS A SURPLUS LINE COVERAGE UNDER THE SURPLUS Commercial Crime Coverage Part $ NOT COVERED LINE INSURANCE LAW, O.C.G.A. Commercial Inland Marine Coverage Part $ NOT COVERED CHAPTER 33-5. Professional Liability Coverage Part $ NOT COVERED Liquor Liability Coverage Part $ NOT COVERED Commercial Umbrella Coverage Part $ NOT COVERED - Owners Contractors Protective Coverage Part $ NOT COVERED TRIA $ NOT COVERED 6. TOTAL PREMIUM PAYABLE AT INCEPTION $ 710 . 00 Policy FEE $ 75 . 00 State Tax $ 31.4 0 Other: $ TOTAL $ 816 .40 7 FORM(S)AND ENDORSEMENT(S) MADE A PART OF THIS POLICY AT THE TIME OF ISSUE:* AS PER FORM COMSCHD(10/00)ATTACHED *Omits applicable Forms and Endorsements if shown in specific Coverage Part/Coverage Form Declarations. THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART DECLARATIONS, COVERAGE PART COVERAGE FORM(S)AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. Agency Code: 02279 Continental Special Risks, Inc. By P.O. Box 1820 Authorized Representative Roswell, GA 30077 SGP/EEC 09/21/06 S1100(01/03) INSURED Stock _ COMMER 3IAL GENERAL LIABILITY COVERAGE PART Company DECLARATIONS * Groupk* - • POLICY NUMBER; PAC6628404 1. NAMED INSURED: SOLOMON LANDSCAPING&TREE SERVICE THOMAS EDWIN SOLOMON 2. LIMITS OF INSURANCE-INSURANCE APPLIES ONLY FOR COVF.,RAGE FOR WHICH A LIMIT OF INSURANCE IS SHOWN. General Aggregate Limit (Other than Products/Completed Operations) $1, 0 0 0, 0 0 0_ Products/Completed Operations Aggregate Limit $1, 000, 000 Each Occurrence Limit $1, 0 0 0, 0 0 0 Personal &Advertising Injury Limit $1, 0 0 0, 0 0 0 Damage to Premises Rented to You Limit $5 0, 0 0 0 any one premises Medical Expense Limit $5, 0 0 0 any one person 3. LOCATIONS of all premises you Own, Rent, or Occupy Address City State Zip No. 1 P.O. BOX 13 TYBEE ISLAND GA 31328 PREMIUM BASIS RATES ADVANCE PREMIUM 4_ CLASS** Code/Exposure Prod/CO All Other Prod/CO All Other **If Classifications are Numbered,the coverage applies to the corresponding Location No. No. 1 97047 p) 12,200 INCL 19.12 INCLUDED 234.00 PAYROLL LANDSCAPE GARDENING (NO DUSTING, SPRAYING, OR FUMIGATING) No. 1 99777 p) 12,200 INCL 39.04 INCLUDED 476.00 PAYROLL TREE PRUNING, REPAIRING,TRIMMING (NO DUSTING, SPRAYING, OR FUMIGATING) No. No. No. **If Classifications are Numbered,the coverage applies to the corresponding Location No. TOTAL: $ 710 .00 (s) gross sales-per$1000 (c) total cost-per$1000 (m)admissions-per 1000 (e) each (p) payroll-per.$1000 (a) area-per 1000 sq.ft. (u) units (o) other 5. Policy may be AUDITABLE (t) see classification notes in company or ISO Commercial Lines Manual 6. SPECIFIC GENERAL LIABILITY FORMS/ENDORSEMENTS AS PER FORM COMSCHD(10/00)ATTACHED This page alone does not provide coverage and must be attached to a Commercial Lines Common Policy Declarations Common Policy Conditions, Coverage Part Coverage Form(s) and any other applicable forms and endorsements. S2000 (06/01) INSURED 1114(10,S;C;II t 5-fr i e r S Xrip ' ,......„_.. Q2:f GAP L -. L. .... . --p-4 ...., 4:---- IL` ' ns MUSS . Seto{ p�P�10 t�pr �`pp o Jot, Site `�� , 40 item st G°mP yA R owl)o�1on 1�1 Cg�ee,.f Nil oInter' oi cool" Chatham County line In end Stste �diiion . N ,ell'6 is Sct M C� REVIEW FOR CODE COMPLIANCE Vf ' � t§t5 aF Every effort has been made to identify —C • code violations, no oversight by the VP-Lf„+ reviewer shall be construed as authority to violate, cancel, alter or set aside any applicable codes or ordinances. The review and permit should not be construed as a warranty or guarantee. Reviewed By Date t2.21.r)6.r)6 WOODLANDS FINANCIAL LLC D a, D_ 0 C t ed;�- ‘,1 Date: January 22, 2007 ""' ' vx S l ° 0 To: City of Tybee Island Tybee Island, Georgia 31328 We hereby issue an irrevocable letter of credit in your favor for the business of Solomon's Tree Service & Dock Work, LLC in an amount up to $10,250.00, which is available against your draft drawn at sight on Woodlands Bank, bearing the clause "Drawn Under Woodlands Bank ". This letter of credit is specific to the dock work job for Ms. Cindy Cupp, and it pertains to property located at 129 Lewis Avenue, Tybee Island only. The work to be completed pertains to an $8,700.00 job, and the letter can be drawn against solely for uncompleted work or environmental damage as it pertains to the permitted work by the City of Tybee. To drawn on said letter, the City must provide the original letter of credit on or before March 22, 2007, and bank's liability limited to $10,250.00 WOODLANDS BANK B y: 1 S Leo Story, Etecutive Vice -Pres. 308 Charles Street, Box 2329, Beaufort, SC 29902 843/987/0014 p 843/987/0019 f