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Signed FPL Easement ConsentPage 1 of 4 100 E. Ocean Ave, Boynton Beach FL 33435 Phone: (561) 742-6260 Fax: (561) 742-6259 Email: pzmailbox@bbfl.us G:\Departments\Planning & Zoning\PZ Team\Andrew Meyer\Easement Consent Removal Agreement-forms.docx 10/2014, 1/2018, 1/2021, 11/23/22 City of Boynton Beach Planning & Zoning Division EASEMENT CONSENT To: _____________________________________________ Name of easement holder Address: _____________________________________________ _____________________________________________ _____________________________________________ Gentlemen: I am the record titleholder of property located at ____________________________________. I propose to apply for a permit from the City of Boynton Beach to construct or install a ______________________________ in the ____________________ easement on my property, legally described as: Lot _______________ Block _____________ Subdivision ____________________________ or Metes & Bounds ____________________________________________________________ ____________________________________________________________________________ Please complete the section below indicating your approval or disapproval of this work. I understand that you will not be responsible for repairs to, or replacement of, any portion of the above referenced improvement and that any removal or replacement of this improvement necessary for your use or access to this easement will be performed at my expense or my successors in interest. ___________________________________ Owner's Signature & Date _________________________ Owner’s Phone # ___________________________________ Owner's Signature & Date ACKNOWLEDGEMENT: I/We (agree) (do not agree) to the proposed improvement under the circumstances described on pages 3 and 4 of this document. _________________________________________________________________________________ Name of easement holder(s) By: ____________________________________ Title: ______________________________ Date: __________________________________ Page 1 of 4 Page 2 of 4 100 E. Ocean Ave, Boynton Beach FL 33435 Phone: (561) 742-6260 Fax: (561) 742-6259 Email: pzmailbox@bbfl.us G:\Departments\Planning & Zoning\PZ Team\Andrew Meyer\Easement Consent Removal Agreement-forms.docx 10/2014, 1/2018, 1/2021, 11/23/22 EASEMENT HOLDERS To assist you in identifying potential easement holders, the following list is being provided. Please be advised that the contact information of the easement holders provided herein may change from time to time without prior notice to the City, the list is not inclusive, and other entities may have easement rights. The list serves general contact information purposes, and it is the applicant’s responsibility to identify all easement holders. NOTE: A copy of a survey must be provided with each consent form when submitting to the easement holder. CABLE: Comcast M-F 8AM-5:30PM, Sa 9AM-1PM 3960 RCA Blvd., Suite 6002 Palm Beach Gardens, FL 33410 Email: Daniel_Tiburcio2@comcast.com Attn: Daniel Tiburcio Comcast PBC Construction Dept. (Allow 1 week for return email) *Do NOT send request via U.S. mail GAS: Florida Public Utilities M-F 8AM-5PM Phone: 561-832-0872 Fax: 855-212-5011 Attn: Engineering Department Email: Engineering-wpb@fpuc.com P.O. Box 3395, West Palm Beach, FL 33402-3395 (For mailing: include self-addressed, stamped envelope) ELECTRIC: Florida Power & Light Company M-F 7:30AM-4PM Phone: 561-616-1601 Fax: 561-616-1625 Email: DCP-Group.SharedMailbox@nexteraenergy.com 9329 S Military Trail Boynton Beach FL 33436-2901 (www.fpl.com) TELEPHONE: BellSouth Telephone / AT&T M-F 8AM-5PM AT&T Engineering Department 321 SE 2nd Street, Delray Beach, FL 33483 Email: g44488@att.com **Use Subject Line: Easement, <job address & city> (Example: Easement, 123 Sesame St, Boynton Bch) Note: Only accepting emailed requests WATER/SEWAGE: M-F 7:30AM-4:00PM City of Boynton Beach Utilities Dept. Phone: 561-742-6400, option #2 Email: easementconsent@bbfl.us 124 E Woolbright Road Boynton Beach FL 33426-6040