0 Sturdivant Avenue RE 170682 0000 TREE25-0033 05.04.2025 SC TRU REMOVAL PERMIT APPLICATION
{ City of Atlantic Beach
CLASSIFICATION Community Development Department -
rArl
800 Seminole Road Atlantic FL PERMIT
(P) 904-247-5800
PERMIT FEES
PERMIT REQUIRED FOR REMOVAL
Other 250.00
f.
F TREES 8 INCHES DIAMETER T
lam— "Please submitin
BREAST HEIGHT AND I E TEI form p�r���
or to
11dng-4gpt@coab.ws
SITE INFORMATION
ADDRESS 0 Svdivant Ave AtlanticBeach FL 32233
APPLICANT INFORMATION
NAME Zwn Jazr. wi, authorized signor of Target 4 LSC OWNER LEGAL AUTHORIZED AGENT
ADDRESS 1718 capitol Ave CITY Cheynne STATE wy ZIP CODE 82001
PHONE +1 ( , 707-4414 EMAIL zain@jazrawi nye
EN FOR I REE REMOVAL
Parking spaces nc % enough for business
TR,r,-..C. RPERMIT APPLICATION PACKAGE CHECKLIST
- .
PLEASE A - [A�-- H THE FOLLOWING EXI-IIBIT -,
*Add itior. i I information may be required, depending upon circumstances unique to individual application
F.XHiSIT . - TREE PERMITTING PROCESS
EXHIBIT I 'Option 1 ) - PROOF OF OWNERSHIP: Copy of Warranty Deed that verifies record of owner
EX HI8IT I j (option ) - LETTER OF AUTHORIZATIO N: Please complete if the applicant is not the owner
E HI13IT ( - TREE INVENTORY and SITE PLAN
F. HIBIT ! - TREE WORKSHEET
I HEREBY C E RTI F` THAT A LL I N F ORIS ATI ON PROM D F D I N TIS I S APIA LI CATI ON I S COR R ECT. f AG R EE TO COMPLY W ITH ALL
PROVISIONS OF C HAPTE R 2 (PROTECTION OF TREES AND JCA TURA L VEGETA TION) AN D A LL OTH ER APPLICA 0 LE CODES A N D
1OR DI•NAN ESr OF YWE CITY OF ATLANTIC B EAC H.
Zaire Jazrawi /1 B125
L..5900A ffL v0won orET TE 0 40
YMOP
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13
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Signed a rid o before a on t h is day of �
by State of
County of '�\tA
ldentikdtion eri +ed: Flor,\ J,
Oath Sworn; Yes N
. . NOWY clic - Sute of fkwida Notary Signature
Commis4on I HN 411098
. op .r y C m. Expleet ,Jan 21 , 2028
I Com i si n e Ire
d0d V Sh Nat iona I Notal Am. ! --
i
. .Pd EXHIBIT is TREE PERMITTING PROCESS
City of Atlantic Beach
Community Development Department
� 00 Seminole Road Atlantic Beach FL 32233
j (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 s rgn the bottom of this page to ce i that you have read this
a
document and understand the permitting process .
BEFORE PERMIT ISSUANCE
1 . Submit Completed Application
* All trees on property must he labeled on Exhibits C and D.
. Schedule Inspections
9 Alf trees to he removed must be labeled with red or orange tape or ribbon and numbered per Exhibit C.
* If th �re is construction on property, a barricade inspection will also he done at this time
Call for more information at (904) 247-5847.
3. Mitigation Assessment
• Mitigation shall be in the form of p res -y ati on or relocation of existing trees, replacement with new trees or
payment into the tree fund . See Section 23 -33 for more information.
9 Staff will review the Trees proposed for removal and send the applicant a Tree Permit Calculations sheet
he el outlines mitigation that is owe ,
4, Proposed Mitigation Replacement Plan
Submit a mitigation replacemarpt plan within 30 days of receiving the mitigation calculations.
The proposed plan rust include a site plan, proposed species, and sic( ). plans must account
for all inches oared ,
MITIGATION PLAN MUST BE SUBMITTED AN D APPROVED PRIOR TO REMOVAL OF I DENT1 F1 E D TREES.
AFTER PERMIT ISSUANCE
S. Permit Issuance
4
When the permit is approved, staff will place a. sign in the yard and contact the applicant. This sign mut r
remain until the permit is final d .
If paying for mitigation, payment ,jo+ hF made within 7 days following the issuance of the permit.
. Mitigation R ptace ent
L
Replacement trees must be planted within 30 days of permit issuance or prior to issuance of a Certificate of L
Occupancy or certificate of
Completion -
E
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 perm-it is fi na I d -
a i n Jzrai 4Y1 8/25
JRE OF P1 T PRINT OR TYPE IAME DATE :}
a
ThE
f [ j PER M I T APPL ICA TjQN EXH181 T A Tree Permitting ProCej 5 03. 15.2024
i'
1
.•i =-'�'� �� EXHIBIT B : LETTER QF AUTHORIZATION
City of Atlantic Beach
+� rf 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 Zaire Jazrawi, authorized signer of Target 4 LLC PHONE # +1 (904) 707-4414
ADDRESS 178 Capitol Ave EMAIL zaingjazrawi .me
CITY Cheyenne STATE WY ZIP CEDE 82001
AGENT INFORMATION
NAME PHONE #
ADDRESS EMAIL
CITY STATE ZIP CODE
_ i5 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 ether such proof of ownership as may
be required in avplying to the City of Atlantic Beach , for an application related to a Tree and Vegetation Removal Permit,
HEREBY CERTIFY THAT ALL INFQRMATIQN PROVIDED IS CORRECT: Sig nature of Property Owner(s)
SIGNATURE OF OWNER PINT 0R TYPE NAME DATE
SIGNATURE OF OWNER #2 PRINT OR TYPE NAME DATE
�.��
to r,
Signed and sworn before me on this day of � by State of
'00Z ok �S0"�-CCounty of JL JIL �
Identification ver If ed: L-0
� �
Oath Sworn: [] Yes No ~
fo eAA041 �k�, S�tEE� R►�QH�u otary Signature
r +r'otery public State of FSorfoa ' �Commitslon � HH 4�3�4aµy Comm. Expires ��n 1f, 20lS y CommMssion expires
I�
TREE REM avA[ PERM RAPPI ICA TrQn►- F
-A�j' EXHIBIT Co. TREE INVENTORY and SITE PLAN
City of Atlantic beach
z} Community Development Department FOR INTERNAL OFFICE USE ONtY
- ` = •'�- ,:� S00 Seminole Road Atlantic Beach, FL 32233 CLASSIFICATION
(p) 904-247-5800 ---- -PERMIT #
TREE INVENTORY- Please sketch an inventory in the area below or attach a site plan showing all existing tries on the
property below that are 8"' diameter at breast height (dbh) and greater. Please complete the following:
• Show the location of all trees to be removed with an "X" 0 Shaw the location of all trees to be preserved with
• Show the location of all trees to be relocated with an "Q" • Shaw all existing and/or proposed buildings
0 Number all trees and list on EXHIBIT D: Tree Worksheet
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PREPARED BY; Zain Jazraw+ SCALA: 7 SQUARE .
TREE RfMQVAL PERM NTAPPf ICA T)ON - fXHrBITC, Tree inven[orla nd qrCe Plon 03, 15.2024
EXHIBIT D -ep TREE WORKSHEET
r r
City of Atlantic Beach
r) Community Development Department
800 Seminole Road Atlantic Beach, FIL 3Z233
(P) 904-247-5800
List the species aid diameter at breast height (dbh' of all trees identified on EXHIBIT C (atta ch add itianal pages as needed) .
i
ir �r�
yi ! O
ID DBH SPECIES �' COMMENTS (for use by City Staff)
removing preserving relocating
por---------w
1 8 Red or silver maple
'I por
Z
3
4
S
6
7
S
9
10
11
12
13
14
15
lb
17
18
� 19
as
xi
22
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23
wmrwmmnm�
24
xs
TREE REMOVAL PERMIT APPLICATION - FXN16ITD: Tim Wo►kShtff O? 15.1024