361 AHERN POD REG AUG-22-2013 11:21 FROM: TO:2475e45 P.1
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City of Atlantic Beach 800 Seminole Road •Atlantic Beach,Florida 32233-5445
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RIEGISTRATION FORM
FOR TEMPORARY STORAGE STRUCTURES '
Portable storage structures may be used within the City of Atlantic Beach following submittal of this completed
form to the Building and Zoning Department. Within all residential Zoning Districts, these may be used only for
the temporary storage of personal household belongings of occupants of the property and may be placed on the
property for a period not to exceed'0-4u �(4)�d#iy` r'nirlety-six, (96) hours, Registration is required tach time that a
temporary storage structure is placed on the property, In the event of damage to a residence by fire, storm, flood, or
other such property loss, this period of time may be extended to ten (10) days upon-request to iLnd-written approval
of the City Manager- Within all non-residential Zoning Districts, enclosed portable storage structures may be used
for temporary storage of items related to the business located on the property, for a period not to exceed thirty (30)
days. Such structures cannot be located within front yard setbacks and shall not be sed to store any chemical:
hazardous, flammable or combustible materials, DATE 43
APPLICANT NAME: 3,eRc1-foi :3 —• op'n q1 In
MAILING ADDRESS:
A.DDIZLSS WHERE TEMPORARRAGE STRUCTURE WILL BE PLACEDiff rent fro
tndiling address,) / ) / r'1 571 32-2-2'
SUBDIVISION BLOCK# LOT#
DATES THAT THE TEMPORARY STORAGE STRUCTURE WM E LOCATED ON T
PROPERTY: f`a? 1 through
residential property
❑ Commercial (,provide survey or site plan showing location where structure will be placed,)
❑ other `
1 HEREBY CERTIFY TRAT ALL INFORMATION PROVMBWfih s " .Storms ldet,Ewt
Signature of property owner or authorized agent, 904.37&845
SIGNATURE PRINT NAME
CONTACT INFORMATION OF PERSON SUBMITTING THIS REGISTRATION FORM (rixAsr ntzT)
NAME
MAILING ADDRESS
PHONE PAS+. E-MAIL