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Temp. Use Permit - Alley Use - BOCC Construction Trailer City of Okeechobee 55 S.E. 3rd Avenue Okeechobee, Florida 34974 (863) 763-9821 Temporary Use Permit Permit Number: 19-005 Date(s) of Event: September 18, 2019 to finish (Tentative finish date 5/25/2020) Permit Expiration: 5/25/2020 (tentative finish date) 11:59PM In connection with Purpose of Request: Temporary Construction Trailer Development Permit # 19-08-324 Property Owner: Okeechobee County Address: 409 NW 2nd Avenue, Okeechobee, FL City: Okeechobee State: Florida Zip Code: 34972 Applicant: Native American Construction Applicant's Address: 2971 SW 3rd Terr., Okee., FL Phone Number: 863-824-6727 Address of Project: 409 NW 2nd Ave., Okee., FL Current Zoning: Public Use (PUB) FLU Designation: Public Facilities (PUB) Subdivision: City of Okeechobee Restrictions/Remarks: All debris must be removed upon final completion date. Owner understands and agrees to the following: X Issuance of a permit may be subject to other conditions and time limitations. X Issuance of a permit is not authorization to violate public or private restrictions. X Failure to comply with applicable regulations may result in withholding future permits. X There may be additional permits required from other governmental entities. Appli' nt's Signature T7\ Date i t _� J " IJ S 18, -2019 Administrative Secretary REF:.ORD.716,Temporary Structures TEMPORARY PERMIT APPLICATION +isic y.oF•o"�e�od `,.A4„ , �� STRUCTURES IN CONNECTION WITH DEVELOPMENT PERMIT (664) ",7''''"--1A i;' City of Okeechobee-General Services Department 'r_*its , ���� 55 SE 3rd Ave,Room 101,City Hat,Okeechobee,FL 34974 ��"'�%c'�`���' Phone:(863)763-3372 ext.9821 DATE RECEIVED: 47/i 7/) q DATE ISSUED: tih�/�5 APPLICATION NO.: /41 _0 0 5 CONSTRUCTION DATE(S) e1:2 k 4 _ SAC/A. FEE:$175.00 X tP j 41'/61-1 DATE PAID: q/oh 1 E5 Name of Property Owner(s): $ & - it i• of sib 4.,.46 (I, •-P 6 it O sffi G." Address: I-100 NW IL)ve SU 1-+'c C. O or-technbecI FL- T. Telephone Numbers: .. Home: Work: $193-1(¢3-08C 5 Cell: 11 Name of Applicant: Na-h V. Ame riC Cir Coolat-yuction LL Address: aq-t I Sw 3rd TTrracc oheecncioe e 1 ct. 34q1U Telephone Numbers: �. 1� Home: 8(.03-�,u-i 1a1 Work: Cell: 4:!- 71 ; -c �� 3c iC,1 Future Land Use Map Desigation: P U 17 Current Zoning Designation: PIJ,F) Legal Description of Property: L('t4 ?c Cise,e°(;Y1c%brf' eD\OcV t t "I Address of Property: 9 oci (3 of And rw c ()hem I' u e-c, \-7-7 I__. ._2*-K I t( I Please Explain Type of Use: N QV\i Cs,nstyocho Briefly describe use of adjoining property North: Sc 1C ;) `aI,F neSS East: N I Q South: C, r n 1- 1 IN' West: (•ULA r-k-Ku?cf Temporary structures in connection with a development permit are as follows: temporary construction office, real estate office, watchman's office and model home on the property under development. Attach the following documents: 1. Notarized letter of permission, if applicant is not the property owner. 2. Proof of liability insurance paid in full for length of permit in the amount of$1 million per occurrence. City Staff(Please review the application,attach comments or special conditions). Occupational and.or State License Verification , 9 tJY PA LJ ZL_J' Date: , "- I 'g 1` 9 Fire Department Approval: �� Date: I g- S El,-021)/ Police Department Approval:�, % 9* Date: j --�8/ �f Public Works Department Approval: j ci Date: I 't k( J 40 Building Inspector Approval:' yip/ __ "*. Date • 11; 'I7 City Administrator Approval: a. j Date: 0 7 I hereby certify that the information on i application is correct The information included in this application is for use by the City of Okeechobee in processing my request. False or n7 ireding jnformation maybe punishable by a fine of up to$500.00 and imprisonment of up to thirty days and may result in the summary denial of this application. ( dZi VI i ° yL/31ol(,i Signature of Applicant Date Revised 1!5118 Jd TEMPORARY RIGHT OF WAY LICENSE AGREEMENT THIS LICENSE AGREEMENT made and entered into this j 7i,day of September,2019,by and between The City of Okeechobee, a Florida municipal corporation hereinafter referred to as the "City" and Okeechobee County, a political subdivision of the State of Florida„hereinafter referred to as the"County". WITNESSETH WHEREAS,the City,owns the right-of-way for NE 3`d Avenue lying between NE 4th Street and NE 5th Street which is located adjacent to the west property line of County owned real property upon which a public building will be constructed;and WHEREAS, the County has requested the City to permit its use of the east portion of NE 3`d Avenue to locate a construction trailer during the construction of a public building in a manner that will not prevent continued normal use of NE 3`d Avenue;and WHEREAS,the City has agreed to permit the County to use a portion of the right-of-way until such time as the new building obtains its certificate of occupancy. NOW THEREFORE,in consideration of the premises,and the mutual promises and undertakings herein contained, and of other good and valuable consideration,receipt of which is hereby acknowledged,the parties agree as follows: 1. City hereby grants to County a temporary license in and to the unpaved eastern portion of the NE 3th Avenue right-of-way,lying between NE 4th Street and NE 5th Street,and continuing until the building being constructed on the adjacent real property obtains a certificate of occupancy or this License is terminated as hereinafter provided. 2. The City may terminate this License at any time,by giving written notice to the County,specifying the date of termination,such notice to be given not less than thirty(30)days prior to the date therein specified. 3. COUNTY agrees to contact its insurance underwriter and request a rider be added to its coverage with a certificate furnished to the CITY showing the portion of the alleyway as herein described,to be used by it,insures the CITY against any liability arising out of alleged injuries or other activities which may occur which the alleyway.Regardless,to the extent permitted by law, without waiver of sovereign immunity, the County will indemnify City against all actions, claims, demands,liabilities and damages which may in any manner be imposed on or incurred by City as a consequence of,or arising out of this License. IN WITNESS WHEREOF the parties hereto have executed this License Agreement the day and date first above-written. The Ci . i I eechobee,Flo . • ft � by disi'm - cos Montes De Oca,City Administrator jOird itness Okeechobee County,Florida by L Witness Robbie L.Chartier,County Administrator itness 7271-428765.WPD Board of County Commissioners °BSE o Okeechobee County Y � •""111,117• 4-oRto' Facilities Maintenance & Development Services 1700 NW 9th Avenue, Ste C Okeechobee, FL 34972 September 11, 2019 City of Okeechobee Attn: Jackie Dunham 55 SE 3rd Avenue, Room 101 Okeechobee, FL 34974 Dear Jackie, On behalf of Okeechobee County Board of County Commissioners, I give Native American Construction, LLC permission to park a 40' construction trailer on site during construction of the new Property Appraiser, Tax Collector and Driver License Building. Please contact me if you have any questions. Thank yo 1(_ 7Z Do ie Oden, Director Facilities Maintenance & Development Services David Hazellief Bryant H.Culpepper Bradley G.Goodbread Terry W.Burroughs Kelly Owens District 1 District 2 District 3 District 4 District 5 lDATE(MM/DDIYYYY) O ACRO® CERTIFICATE OF LIABILITY INSURANCE kor.------ 09/17/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jenna Jennings NAME: World Risk Management LLC a member of: PHONE (407)445-2414 FAX (A/C,No,Ext): (AIC,No): (407)445-2868 Ballator Insurance Group EMAIL ) )ennifer.'ennin9 s wrmllc.com ADDRESS: 20 N Orange Ave Ste 500 INSURER(S)AFFORDING COVERAGE NAIC# Orlando FL 32801 INSURERA: Public Risk Management of Florida 58159 INSURED INSURER B: Okeechobee County BOCC INSURER C: 304 NW 2nd Street INSURER D: Room 109 INSURER E: Okeechobee FL 34972-4187 INSURER F: COVERAGES CERTIFICATE NUMBER: CL199401671 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD MD POLICY NUMBER (MM/DD/YYYY) (MMIDDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED 2,000,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ Excluded A Y PRM019-006-035 10/01/2019 10/01/2020 PERSONAL&ADV INJURY $ 2,00 0,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG _$ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000 (Ea accident) _ X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED PRM019-006-035 10/01/2019 10/01/2020 BODILY INJURY(Per accident) I $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) X Comp X Coll Comp/Coll Deductible $ 1,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE ETH AND EMPLOYERS'LIABILITY Y/N A ANY PROPRIETOR/PARTNER/EXECUTIVE NIA PRM019-006-035 10/01/2019 10/01/2020 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 10 , 00000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) City of Okeechobee is additional insured only for Okeechobee County BOCC's liability or negligence,but not the City of Okeechobee's negligence,per FL Statute 768.28. With respects to the listed coverages held by the named insured,as evidence of insurance. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Okeechobee ACCORDANCE WITH THE POLICY PROVISIONS. 55 SE 3rd Ave AUTHORIZED REPRESENTATIVE Okeechobee FL 34974 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD A ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)9/12/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Waldorf Insurance& Bonding, Inc. PHONE Ben French FAX 45 Eglin Pkwy Ste 202 (A/C.No.Ext):850-581-4925 (A/C,No):850-581-4930 Fort Walton Beach FL 32548 ADDRESS: receptionist@waldorffinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Southern-Owners Ins.Co. 10190 INSURED NATI-01 INSURER B:Auto Owners 18988 Native American Construction, LLC 2971 SW 3rd Terrace INSURER c:Builders Mutual Insurance Co. 10844 Okeechobee FL 34974 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:122072815 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP W /YLIMITS LTR INSD VD POLICY NUMBER (MM/DDYYY) (MMIDD/YYYY) A X COMMERCIAL GENERAL LIABILITY 78676439 6/5/2019 6/5/2020 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $300,000 X XCU MED EXP(Any one person) $10,000 _ PERSONAL&ADV INJURY $1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X 7N i LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY 4767643901 6/5/2019 6/5/2020 COMBINED SINGLE LIMIT $1,000,000 CO accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ A X UMBRELLA LIAB X OCCUR 4846390100 6/5/2019 6/5/2020 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTION$ $ C WORKERS COMPENSATION WCP 1059383 01 6/5/2019 6/5/2020 PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE Yr7 N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 A Leased/Rented Equipment 78676439 6/5/2019 6/5/2020 Limit 76,000 Deductible 250 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The following Members are excluded from Workers Compensation and Employers'Liability: Martin Johns and Wesley Harvin II. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Okeechobee 55 SE Third Avenue AUTHORIZED REPRESENTATIVE Okeechobee FL 34974 I . ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD re willif ---.---<", III ll'jit' -. .. A 11 f .y .M Mr•,.***. `.i. • R _ ��.//! any �'.r- � y�. litil."-- f f,k� /�� 0 - ! 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Mini Str KIM w.Nrxmwowru ARCHITECTURAL rORMISI.rreca ar+rNT SITE PIAN LEGAL OESCSIVIION AO10 LOCATED IN SECTION 15.TOWNSHIP]t SOUTH,NANOF 35 EAST.OKEECHOBEE COUNTY,FIA �� ii - I \\\ T \\ \\\ -\`- STRAUGXN TROUT I W.�'C� R�� 1. \ \. a1 1 A•� `4 I -705; rts" [I "or. ,§1 ' I I 17 % rrz S . % • why, o i T volim= Lamm , jI qFc IOI � � % /■- 1 1010191P81171 I W KWON l I °� , W,m��T • Sra as `I NQQ CO W M P.,5•2 ® 11m,�,11� O ' K m p O.W O_ II ®I C1 Wo 0 ow y I I I �m I oho � 1 I I I°L ^' I JZW 1 PROPOnYM[ • W 0 El Y �° e.r g �� ' �, zaj0 -: <.:c iI o F- _ _�_J_ _ _ — — — _ MY�iMI T 1BIMsl10£T STA PROJECT 0. 1800 `�rPROJECT MGM.: KM �� ® \\\ \\\\\\\\\\\\\\\\\\\\ DATE ISSUFA A8 \ I 00.x.18 SDoOCO cs \\}\I .0818 SDOOCS FE 09.181! SD DOCS.REV 00.18 18 SITE RIM REV ..SIIII 11.07.18 CO DOCS. ARCHITECTURAL SITE PLAN 021E19 034COS SCALE uw+=ra 0.3 2E10 10014 COS 01.15.15 PERMIT SET ON-SITE PARKING STALLS:85 05311 AODENDUYA] NO GIVE ENGSIEEMWG DRAWINGS ARCHITECTURAL FOR ADDITIONAL SITE DEVELOPMENT SITE PLAN . LEGAL DESCRIPTION: A010 LOCATED IN SECTION 15,TOWNSHIP 37 SOUTH,RANGE 35 EAST,OKEECHOBEE COUNTY,FIA. BOUNDARY AND TOPOGRAPHIC SURVEY PROPERTY APPRAISER,TAX COLLECTOR AND DRIVER'S LICENSE BUILDING SITE LOCATED IN SECTION 15,TOWNSHIP 37 SOUTH,RANGE 35 EAST,OKEECHOBEE COUNTY,FLA. i 1 • N a k RIMY NILL MD PSK_ ePo9 I 1 I 1 I I g It. BLOCK 93 "7144 17 271' as BLOCK 92 I BLOCK 91 GE9Aan. F,,' r� �,� ., I I I I r 1 a 1 rxm . 26 avow\ \ 1\I � \ \ �\ \ '\ I I Aa — - _ — . — •1,.,— _._._._ 370.-06) -- — — — — mss —.D. — — - 30 I o 6/J 40 no(7 0 30 60 90 I OM N.W.5th STREET(F)ELEVENTH STREET-(P) \ I ._. SCALE: t'= 30' o NAT 0A xp ,—.—. — ,�. a— — n 6/o \ v Tor SAM VIA s tea, _ ''.P.ow •LIr-— — '—.,N am— ,.--.. ---,.9 .. �� �" -,.:„, Ie" "7 N 8948'01 E 35032'-(F)300 (P) �'TT -�, LEGAL DESCRIPTION • �g 1s OW I as � ryT'd Last Mull 12.BImk10T,NW also 1110201NA exe,'mre bd..,Las 1,Z$LS,6Bak ~'Sg nj i�(„ g 810 a.a T� -'� 107edLas2.O.9,10.11,12.E.My.FiClusl,obee.es recs..]in RN BsokS.Pape 5, UppB Ann:VOW YON.3 3I I I I I I 1=7,-t '`66/ ! NV N mW I %tic RAM.of Olwed10.11Canty.Elaka. N KM VAAL•LILA LC RCP lU`UVV CW®ri,p 90.058 sage I..WO]saes),man a less. 16/ (a i a. , D.e. I s — ,""SPAN WOO•u o•ALA No, < I I W .”` x�a +p➢ I I I I SURVEYOR'S NOTES a_03 8:- "6faMr.un rW NO O eo I I 1'17' r~/1 6 5 4 I 3 I 2 1 1 O I 1.)100371 ma Ne[wrings than Mem eebaMmFlvida Slele Nene CmdMa.Rake b Z l ir" PMZmeWivgCher'pim TKO GNSS RIKraroiws end a net..soLEm Paidel00w g c. $F Flake Daps..DTrespMN'm FAIN ne nark WAN Misery slims m RIKaaaayel SI fy ,aa .I I Ia-e n:. 1 as.,. 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