1144 E Coast Drive TREE25-0012 SC TREE REMOVAL PERMIT APPLICATION
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City of Atlantic Beach FOR INTERNAL OFFICE USE ONLY
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CLASSIFICATION
Community Development Department ATION
!� 800 Seminole Road Atlantic Beach,FL 32233 PERMIT# _ f ` �d 1
o (P)904-247-5800
PERMIT FEES
PERMIT REQUIRED FOR REMOVAL Single-/Two-Family Residential $125.00
OF TREES 8 INCHES DIAMETER AT ❑ Other $250.00
BREAST HEIGHT AND GREATER %'; R
SITE INFORMATION
ADDRESS `A L ", C(K- .
APPLICANT INFORMATION
NAMEoo Q./ [�-01NNER ❑ LEGAL AUTHORIZED AGENT
ADDRESS I [,� L Uc..� • CITY STATE _F�(_ ZIP CODE
PHONE# 1 4 y 2_ EMAIL �S�Y�` ✓ (
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 OF TREES AND NATURAL VEGETATION)AND ALL OTHER APPLICABLE CODES AND
OR,. NANCES OF THE CITY OF ATLANTIC BEACH.
26) 0_5
51 7URE OF OWNER or AGENT PRINT OR TYPE NAME DATEI
Signed and sworn before me on this day of zo-z _by State of f
County of y Q-`
Identification verified: t J
Oath Sworn: ❑ Yes N
TONI GINDLESPERGER
MY COMMISSION#HH 407122 Notary Signature
EXPIRES:October 6,2027
My Commission expires
TREEREMOVAL PERMITAPPLICATIONO3.15.2024
G EXHIBIT A: TREE PERMITTING PROCESS
City of Atlantic Beach
1 � Community Development Department
800 Seminole Road Atlantic Beach,FL 32233
Wil- ! (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 certify 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
• A re planted and/or construction is complete, a final inspection must be scheduled.
rees lante , preserved and relocated must survive three (3)years following the date the permit is finaled.
A—
SI&UTtJRE OF APPLICANT PRINT OR TYPE NAME DAT
TREE REMOVAL PERMITAPPLICATION-EXHIBITA:Tree Permitting Process 03.15.2024
EXHIBIT B: LETTER OF AUTHORIZATION
\� City of Atlantic Beach
1
Community Development Department
800 Seminole Road Atlantic Beach,FL 32233
"L or (P)904-247-5800
"Please complete if applicant is not the owner
OWNER INFORMATION 2 /)
��[ ( `✓"� — '2-
J GII/
NAME PHONE#
ADDRESS I y ��61---3 4- e— EMAIL F
CITY �j STATE (_ ZIP CODE 3 L 3
AGENT INFORMATION
NAME PHONE#
ADDRESS EMAIL
CITY 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 IFY THAT ALL INFORMATION PROVIDED IS CORRECT:Signature of Property Owner(s)
2�
S GNATIrBE-OF°OWNER PRINT OR TYPE NAME- DATE
SIGNATURE OF OWNER#2 PRINT OR TYPE NAME DATE
Signed and sworn before me on this . yday of y State of
TD ountyof L)1r(D(—
Identification verified:
Oath Sworn: ❑ Yes N
•=osP�y?y�c, TONIGINDIESPERGER
(COMMISSION#HH 407122
EXPIRES.October 6.2027 Notary Signature
f OF FVC•
My Commission expires
TREE REMOVAL PERMITAPPLICATION-EXHIBIT 8:Letter ofAuthorization 03.15.2024
Number DBH Tree Preserve Remove Relocate
147' Other ❑ Q ❑
2 26" Oak Q ❑ ❑
3 35" Palm Q ❑ ❑
4 38" Palm Q ❑ ❑
5 39" Palm Q ❑ ❑
6 34" Palm Q ❑ ❑
712" Birch Q ❑ ❑
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