96 Ocean Blvd TREE25-0007 02.01.2025 SC TREE'Ri'MOVAI,I.'IMMIT'APPLIC_'ATION FOR INIF.RIVALOFFICE USE AfAY
City of AtinintiC Beach CLASSIFICATION Developed
Community Development 0epiminent TREE25-0007
800 Seminole Road Atlantic Reach,FL 32233 PERMIT
(P)904-247-5800 PERMIT FEES
r. n single 1 Two-Family Residential $125.00
PERMIT REQUIRED FOR REMOVAL � Other $250.00
7
OF TREES 8 INCHES DIAMETER AT
**Please submit form in person
BREAST HEIGHT AND GREATER t or to buIIdng-dept@cyab.us
SITE INFORMATION
ADDRESS
APPLICANT INFORMATION
NAME �' WNER [] LEGAL AUTHORIZED AGENT
ADDRESS CITY STATE �_ZtP CODE` 2)l.d
PHONE � - �^ D� EMAIL Lj
REASON FOR TREE REMOVAL
The reason for the tree removal is that they are in the way of the footing for the new wall that we have an open permit for
and need this to start the project. Unfortunately the roots are too close to the wall/footing and we need the space open.
Also There are other reasons like designing the backyard with a different tree species in a different location for a later
date ect.
TREE REMOVAL PERMIT APPLICATION PACKAGE CHECKLIST
PLEASE ATTACH THE FOLLOWING EXHIBITS:
*Additional information may be required,depending upon circumstances unique to individual applications
D EXHIBIT A-TREE PERMITTING PROCESS
El 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
D EXHIBIT[-TREE INVENTORY and SITE PLAN
El EXHIBIT D-TREE WORKSHEET
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IN THIS APPLICATION IS CORRECT. 1 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.
SRE OF OW or AGENT PRINT OR TYPE NAME DATE
Signed and sworn before me on this__t]1L—day of �,(o �Q{r �_by State of UA
C
�ja v vvv vd County of
Identification verified �2y g \r
Oath Sworn: Yes KASEYKIN43
*'•, MYCOMMISSIONOHH362760 Notary 4Signature
EXPIRES:Januaiy23,202T t
My Commission expires , { Yl 1 2 t 24L0
TREEREMOVAL PERM1TAPPUCA77ONO3.15.2024
- - EXHIBIT B:LET=OF AUTHORIZATION
_A City Of Manflc Beach
„J.: firaury 4evt4opm#M Uepartrnero
WO 5emin*Rad Ad ak Beach,Fi. 32333
tl'j 904•247-584(1
y_
*•Please complete If applkant is not the owner
OWNER INFORMATION T
AMMS
EMAIL
CETT STATE ZIP CODE
AGENT INFORMATION
NAME � �_ � �, - PHONE u
ADDRESS EMAIL 1 - � •
CITY STATE N7':I_— ZIP CODE
is hereby authorized to act on behalf of
N the owner(s)of those lands described
in the attached application and as dexdbed 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,
a
r
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT:Signature of Property Ownedsl
J'z') r
SIGNATURE OF OWNER PRINT OR TYPE NAME DATE
SIGNATURE OF OWNER#2 PRINT OR TYPE NAME DATE
Signed and sworn before me on this 3 day of --I by State of
County of
Identification verified: r
MY COMMISSION#HH 203374 I
Oath Sworn: �es 0 No ^:: •,� EXPIRES:Novomber30,2025 r 'I-'7� ( -{�
Bonded Thru Notnry Public Undon
Signature CY
1
EXHIBIT A:TRUE 1'1111M1'171NG 1'ItOCESS
City of Atlantic Seach
Conmurnity Development pelmitnlent
800 Seminole Road AtlalStk Reach,FL 32233
"� .�t►° (P)904-247.5800
This document provides in general gulde of the tree removal permitting process. For complete information on
permitting procedures see Section 23-33. Please sign the bottom of this page toSSjo 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 PIAN 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.
b. Mitigation Replacement
i 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
• Aftertrees 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.
SIGNATURE OF APPLICANT PRINT OR TYPE NAME DATE
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