325 8th Street TREE25-0003 01.16.2025 SC TREE REMOVAL PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
City of Atlantic Beach CLASSIFICATION NSW C)M1 MMC%1-[
Community Development Department
800 Seminole Road Atlantic Beach,FL 32233 PERMIT# PD 0
(P)904-247-5800
PERMIT FEES
Single-/Two-Family Residential $125.00
PERMIT REQUIRED FOR REMOVAL - ® Other $250.00
OF TREES 8 INCHES DIAMETER AT
"Please submit form in person
u "
BREAST HEIGHT AND GREATER or to buildng-dept@coab.us
SITE INFORMATION L `
ADDRESS 2rj 911zak- fta l,i�
APPLICANT INFORMATION
NAME 64& G AW" ❑ OWNER ® LEGAL AUTHORIZED AGENT
ADDRESS _S2— �jt`(' CITY STATE �� ZIP CODE 32223
PHONE# 4277 — cfj ) EMAIL S e&wetr�% 310 A\100°c.-wy\
REASON FOR TREE REMOVAL
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TREE REMOVAL PERMIT APPLICATION PACKAGE CHECKLIST
PLEASE ATTACH THE FOLLOWING EXHIBITS:
*Additional information may be required,depending upon circumstances unique to individual applications
❑ EXHIBIT A-TREE PERMITTING PROCESS
❑ EXHIBIT B(Option 1)-PROOF OF OWNERSHIP:Copy of Warranty Deed that verifies record of owner
❑ EXHIBIT B(Option 2)-LETTER OF AUTHORIZATION: Please complete if the applicant is not the owner
❑ EXHIBIT C-TREE INVENTORY and SITE PLAN
❑ EXHIBIT D-TREE WORKSHEET
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IN THIS APPLICATION IS CORRECT. I AGREE TO COMPLY WITH ALL
PROVISIONS OF CHAPTER 23(PROTECTION OFTREESAND NATURAL VEGETATION)AND ALL OTHER APPLICABLE CODES AND
ORDINANCES OF THE CITY OF ATLANTIC BEACH.
D-s—
SIG TURE O NER or AGENT PRINT OR TYPE NAME DATE
Signed and sworn before me on this day of r a�� by State of f `Ur I_ _
r1)�Yl'�_ d LOar J_!�,- County of Q
Identification verified: f L— DC L I wY)6
r
Oath Sworn: es ❑ No
_Ptlii fyo j
PAMELA ELAINE FELICER Notary Signature �d�
o p°� Notary Public,State of Florida ,,`` _' z0'
z Commission#HH 468958 My Commission expires U
TREE REMOVAL PERMITAPPLI comm.exaires Nov.30,2027
EXHIBIT A: TREE PERMITTING PROCESS
City of Atlantic Beach
- Community Development Department
800 Seminole Road Atlantic Beach,FL 32233
(P)904-247-5800
This document provides a general guide of the tree removal permitting process. For complete information on
permitting procedures see Section 23-23. Please sign the bottom of this page to certi that you have read this
document and understand the permitting process.
BEFORE PERMIT ISSUANCE
1. Submit Completed Application
• All trees on property must be labeled on Exhibits C and D.
2. Schedule Inspections
• All trees to be removed must be labeled with red or orange tape or ribbon and numbered per Exhibit C.
• If there is construction on property,a barricade inspection will also be done at this time.
Call for more information at(904) 247-5847.
3. Mitigation Assessment
• Mitigation shall be in the form of preservation or relocation of existing trees, replacement with new trees or
payment into the tree fund. See Section 23-33 for more information.
• Staff will review the trees proposed for removal and send the applicant a Tree Permit Calculations sheet
which outlines mitigation that is owed.
4. Proposed Mitigation Replacement Plan
• Submit a mitigation replacement plan within 30 days of receiving the mitigation calculations.
• The proposed plan must include a site plan, proposed species,and size(s). Plans must account
for all inches owed.
• A MITIGATION PLAN MUST BE SUBMITTED AND APPROVED PRIOR TO REMOVAL OF IDENTIFIED TREES.
AFTER PERMIT ISSUANCE
5. Permit Issuance
• When the permit is approved, staff will place a sign in the yard and contact the applicant.This sign must
remain until the permit is finaled.
• If paying for mitigation, payment must be made within 7 days following the issuance of the permit.
6. Mitigation Replacement
• Replacement trees must be planted within 30 days of permit issuance or prior to issuance of a Certificate of
Occupancy or Certificate of Completion.
7. Final Inspection
• After trees are planted and/or construction is complete,a final inspection must be scheduled.
• Trees planted, preserved and relocated must survive three(3)years following the date the permit is finaled.
r
SIGNATURE OF APPLICANT PRINT OR TYPE NAME f DATE
TREE REMOVAL PERMITAPPLICATION-EXHIBITA:Tree Permitting Process 03.15.2024
EXHIBIT B: LETTER OF AUTHORIZATION
City of Atlantic Beach
Community Development Department
800 Seminole Road Atlantic Beach,FL 32233
(P)904-247-5800
"Please complete if applicant is not the owner
OWNER INFORMATION
NAME -3�4' �JA J"S PHONE# qoq — 272-- 01$24
ADDRESS 325 0-"- St EMAILlJq-r
CITY ,ink\�C Ber'r—� STATE ZIP CODE 32223
AGENT INFORMATION c�
NAME I`I�fK� ►t 11 lnP.�" PHONE#
ADDRESS fD GYf}rC5 ��l!?� EMAIL [' l [z�.� 1�.nC, •G! 4�cyl �
CITY f14� STATE ZIP CODE
is hereby authorized to act on behalf of
the owner(s)of those lands described
in the attached application and as described in the attached warranty deed or other such proof of ownership as may
be required in applying to the City of Atlantic Beach,for an application related to a Tree and Vegetation Removal Permit.
1 HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT:Signature of Property Owner(s)
S G AT RE F OWNER PRINT OR TYPE NAM DATE
SIGNATURE OF OWNER 2 PRINT OR TYPE NAME DATE
Signed and sworn before me on this 1 day of `fl r j C by State of 901 16,0w_
S m m &A_l l, County of V CX
Identification verified: P L t�Q- I
Oath Sworn: rueles ® No
A .0.1.,
PAMELA ELAINE FELKER
o�v p�� Notary Public,State of Florida ' otary Signature
_ Commission#HH 468958
My comm.expires Nov-30,2027 My Commission expires no ��� �y � ■
TREE REMOVAL PERMIT APPLICATION-EXHIBIT&Letter of Authorization 03.15.2024
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rs EXHIBIT D: TREE WORKSHEET
}' City of Atlantic Beach
spa Community Development Department
800 Seminole Road Atlantic Beach,FL 32233
-u (P)904-247-5800
List the species and diameter at breast height(dbh)of all trees identified on EXHIBIT C(attach additional pages as needed).
ID DBH SPECIES X I O COMMENTS(for use by City Staff)
removing preserving relocating
2 1.3 PQM ri-w
3 'Cl
4 ,2 PrArA `TCet. ® -
5 � r0 Pram M. O
$ ► A P FRAM
`fru-
9 1,3 J IAm fre& 9
10 1,4
12
13
14
15
16
17
18
19
20
21
22
23
24
25
TREE REMOVAL PERMIT APPLICATION-EXHIBIT D:Tree Worksheet 03.15.2024