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1209 Beach Avenue TREE21-0056 09.30.2021 SCTREE REMOVAL PERMIT APPLICATION City of Atlantic Beach Community Development Department 800 Seminole Road Atlantic Beach, FL 32233 (P) 904-247-5800 PERMIT REQUIRED FOR REMOVAL OF TREES 8 INCHES DIAMETER AT BREAST HEIGHT AND GREATER SITE INFORMATION ADDRESS FOR INTERNAL OFFICE USE ONLY CLASSIFICATION i�Ey�L PERMIT#�� ��Z� ' �JSCLd PERMIT FEES Single -/Two -Family Residential $125.00 Multi -Family Residential $250.00 0 Commercial /Industrial $250.00 Institutional /Other Non -Residential $250.00 APPLICANT INFORMATION NAME � UD I j ( � . (SC`/�l ADDRESS / �ld�i �t=y4c� PHONE # 0 OWNER 0 LEGAL AUTHORIZED AGENT CITY �����•� �C� STATE � ZIP CODE �,�?.,� EMAIL 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 EXHIBIT B (Option 2) - LETTER OF AUTHORIZATION: Please complete if the applicant is not owner EXHIBIT C -TREE INVENTORY and SITE PLAN SEP EXHIBIT D -TREE WORKSHEET 13� I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IN THIS APPLICATION IS CORRECT. I AGREE TO COMPLY WITH ALL PROVISIONS OF CHAPTER 23 (PROTECTION OFTREES AND NATURAL VEGETATION) AND ALL OTHER APPLICABLE CODES AND ORDINANCES OF THE CITY OF ATLANTIC BEACH. C - ,�� SIGNATU E OF OWNER or Signed and sworn befo Identification verified: Oath Sworn: Yes eon this , � day of U p`'' l �- No 02 TREE REMOVAL PERMITAPPLICATION08.05.2021 PRINT OR TYPE NAME i — �- Notary Sig My Commission expires 9�-�0% DATE State of �� C my of � � e:, PETE LOFTIS �Notary Public -State of Florida c`I Commission � HH 155507 o'' My Comm. Expires Aug 15, 2025 Bonded through National Notary Assn EXHIBIT B: LETTER OF AUTHORIZATION City of Atlantic Beach Community Development Department i� 800 Seminole Road Atlantic Beach, FL 32233 �71VO ��f7 � (P) 904-247-5800 OWNER INFORMATION NAME ADDRE CITY xPlease complete if applicant is not' AGENT INFORMATION ►fgnl� ADDRESS CITY EMAI STATE r ZIP CODE it 4CO EMAIL 'e�t�L Of / 4' STATE ZIP CODE dig w _ is hereby authorized to act on behalf of !1% IV A-0 the owners) 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. I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT: Signature of Property Owners) SIGNATURE OF OWNER #2 Signed and sworn before me on this _(l `� Identification verified: Oath Sworn: �es � No day of dL- V PRINT OR TYPE NAME PRINT OR TYPE NAME Notary Signature My Commission expires 02 TREE REMOVAL PERMIT APPLICATION- EXHIBIT B: Letter ofAuthorization 08.05.2021 DATE DATE X1-1 c; State of Count Notary Public -State of Florida Commission � NH 151502025 uv Comm. Expires Aug A ✓ Prepared by and return to: Robert S. Bernstein, Esq. Foley & Lardner LLP One Independent Drive, Suite 1300 Jacksonville, Florida 32202 cer Pages. 3 Rec01 aed 35.2C 2015 at 03.33 Ptvl Reme Fussed CLERK CiRCUI- C^UR- DU'vAL COUNT' RFCr DROING S'7 00 ESD XST 5C 70 GENERAL WARRANTY DEED Tax Parcel No.: 170290-0000 THIS GENERAL WARRANTY DEED is made this � day of 2015 between JUDITH S. BEAUBOUEF, a single person, whose address is 120venue, 9 e h A Atlantic Beach, FL 32233 ("Grantor"), and JUDITH S. BEAUBOUEF, Trustee`of the JUDITH S. BEAU13OUEF REVOCABLE TRUST, originally dated October 19, 1999, as amended from time to time, whose address is 1209 Beach Avenue, Atlantic Beach, FL 32233 ("Grantee"). WITNESSETH: That the Grantor, in consideration of the sum of Ten Dollars and other valuable consideration paid by the Grantee, receipt of which is acknowledged, has granted, bargained and sold to the Grantee, its successors and assigns forever, the real property located at 1209 Beach Avenue, Atlantic Beach, FL 32233 (the "Property") more particularly described as follows: LOTS 1, 2 AND 3, BLOCK 515 ATLANTIC BEACH, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 65 PAGE 1, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. SUBJECT to covenants, easements, restrictions, and reservations of record, if any. Together with all the rights, tenements, improvements, hereditaments, easements and appurtenances thereto belonging or in anywise appertaining. To have and to hold the same in fee simple forever. THE PREMISES ARE HOMESTEAD PROPERTY OF THE GRANTOR AND WILL REMAIN HOMESTEAD PROPERTY OF THE GRANTOR AFTER CONVEYANCE TO THE GRANTEE. IN ADDITION, THE TRUST DOCUMENT CLERK'S NOTE: THIS GENERAL WARRANTY DEED IS GIVEN TO CONVEY REAL PROPERTY BY GIFT TO THE GRANTEE, THE TRUSTEE OF A TRUST REVOCABLE BY THE GRANTOR. ACCORDINGLY, NO DEED DOCUMENTARY STAMP TAXES ARE REQUIRED TO BE PAID IN CONNECTION WITH THE RECORDATION OF THIS DOCUMENT OTHER THAN THE MINIMUM EXHIBIT D: TREE WORKSHEET City of Atlantic Beach Community Development Department 800 Seminole Road Atlantic Beach, FL 32233 (P) 904-247-5800 List the species and diameter at breast height (dbh) of all trees idented on EXHIBIT C (attach additional pages as needed). ID 02 TREE REMOVAL PERMITAPPLICA TION -EXHIBIT DBH SPECIES X removing [ ] preserving O relocating COMMENTS (for use by City Staffl T- 2 Ig V 3 4 6 f 1� 5 it 6 7 8 9 10 12 l 13 14 Il/0000 15 16 17 �� k 18 i 19 l� / 20 21 22 r 23 `I ' 24 ' 2 25 D: Tree Worksheet 08.05.2021 EXHIBIT D: TREE WORKSHEET City of Atlantic Beach Community Development Department 800 Seminole Road Atlantic Beach, FL 32233 (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 02 TREE REMOVAL PERMITAPPLICATION - EXHIBIT D: DBH SPECIES X removing [ ] preserving O relocating COMMENTS (for use by City Staff) a9 '® 33 3 �,� ►' 3�' � I ► � 31C t 37 J,tloof 321 ;1 II � 91 q 77 1 11 0# 11 C, Ir I r � eb II 41 9b 11 Tree Worksheet 08.05.2021 r ��, t