360 8th Street TREE22-0020 05.12.2022 SCFOR INTERNAL OFFICE USE ONLY
CLASSIFICATION
TREE REMOVAL PERMIT APPLICATION
City of Atlantic Beach
Community Development Department
800 Seminole Road Atlantic Beach, FL 32233
(P) 904-247-5800
PERMIT #/
PERMIT FEES
Single- / Two-Family Residential
J Multi-Family Residential
r~| Commercial / Industrial
0 Institutional / Other Non-Residential $250.00
$125.00
$250.00
$250.00
PERMIT REQUIRED FOR REMOVAL
OF TREES 8 INCHES DIAMETER AT
BREAST HEIGHT AND GREATER
^
SITE INFORMATION
ADDRESS
APPLICANT INFORMATION
S-V
LEGAL AUTHORIZED AGENT
STATE ZIP CODE
^<n:aAV\ t e -
|v| OWNERNAMEv\c
CITY
EMAIL
ADDRESS
PHONE
TREE REMOVAL PERMIT APPLICATION PACKAGE CHECKLIST
PLEASE AHACH THE FOLLOWING EXHIBITS:
'Additional information may be required, depending upon circumstances unique to individual applications
0 EXHIBIT A-TREE PERMITTING PROCESS
EXHIBIT B (Option 1) - PROOF OF OWNERSHIP: Copy of Warranty Deed that verifies record of o'wner
B EXHIBIT B (Option 2) - LETTER OF AUTHORIZATION: Please complete if the applicant is not the owner
gi EXHIBIT C - TREE INVENTORY and SITE PLAN
S 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
ORDINANCES OF THE CITY OF ATLANTIC BEACH.
qiATE
Signed and sworn before me on this _ day of , SfCb^^iSL „ by State of
County of i>jLvra.\
irS& irv«»-L I ^Esfvi ed:Id e ri i f
V
osm:
4:.VN
F. DNO
Notary Signature‘O ^
abee attached (aj I 5My Commission expires
tICATION 06.05.2021(I?
or-
NEW CONSTRUCTION
TREE22-0020
EXHIBIT A: TREE PERMITTING PROCESS
City of Atlantic Beach
fj Community Development Department
/ 7 800 Seminole Road Atlantic Beach, FL 32233
(P) 904-247-5800
llV
5711^
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
l All trees on property must be labeled on Exhibits C and D.
2. Schedule Inspections
l All trees to be removed must be labeled with red or orange tape or ribbon and numbered per Exhibit C.
l 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
l 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.
l 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
l Submit a mitigation replacement plan within 30 days of receiving the mitigation calculations.
l The proposed plan must include a site plan, proposed species, and size(s). Plans must account
for all inches owed.
l A MITIGATION PLAN MUST BE SUBMITTED AND APPROVED PRIOR TO REMOVAL OF IDENTIFIED TREES.
AFTER PERMIT ISSUANCE
5. Permit issuance
l 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.
l If paying for mitigation, payment must be made within 7 days following the issuance of the permit.
6. Mitigation Replacement
l 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
l After trees are planted and/or construction is complete, a final inspection must be scheduled.
l Trees planted, preserved and relocated must survive three (3) years following the date the permit is finaled.
SIGNATURE OF APPLICANT DATIPRINT OR TYPE NAME
02 TREE REMOVAL PERMIT APPLICATION - EXHIBIT A: Tree Permitting Process 08.05.2021
OWNER'S AUTHORIZATION FOR AGENT
^ City of Atlantic Beach
Community Development Department
J 800 Seminole Road Atlantic Beach, FL 32233
(P) 904-247-5800
y.
j-'i
OWNER INFORMATION
NAME Sea Glass MNLIIIc PHONE# 904-349-2803
CELL# 904-349-2803ADDRESS 89 Dewees Ave
CITY Atlantic Beach ZIP CODE 32233STATE FL
AGENT INFORMATION
PHONE# 904-813-3661NAME Mathieu Builders Inc
CELL# 904-813-3661ADDRESS 38 w. 9th St
CITY Atlantic Beach ZIP CODE 32233STATE FL
is hereby authorized to acton behalf of
the owner(s) of those lands described within the attached application and as described in the attached deed or other such
proof of ownership as may be required, in applying to the City of Atlantic Beach, Florida, for an application related to a
Development Permit or other action pursuant to:
0 BUILDING PERMIT □ COMPREHENSIVE PLAN AMENDMENT□ USE-BY-EXCEPTION
0 TREE PERMIT □ ZONING VARIANCE □ PLAT, REPLAT OR LOT DIVISION
□ ZONING MAP AMENDMENT □ OTHER□ SIGN PERMIT
I HEREBY CEfffIFY THAT ALL INFORMATION PROVIDED IS CORRECT: Signature of Property Owner(s) or Authorized Agent
hmarndn
PE1MAMEraafiawNEirI
PRINT5I<
\j
PRINT OR TYPE NAMESIGNATURE OF OWNER #2 DATE
5 ^/V\Oa by State of £USigned and sworn before me on this day of
L-gg ^ rVS(/ ir-x County of
SO' %
Heather Messer
. My Commission # ^HHU2824
Identification verified:
t Ca WV\oOath Sworn: 0 Yes □ No X
Notary Signature
My Commission expires
;; OWNERS AUTHORIZATION 03.01.2018
EXHIBIT B: LETTER OF AUTHORIZATION
k City of Atlantic Beach
5 Community Development Department
/ 800 Seminole Road Atlantic Beach, FL 32233
(P) 904-247-5800
A
**Please complete if applicant is not the owner
OWNER INFORMATiON
G\ass , \\cNAME
^V\q^V\c ^^o.cV\
ADDRESS
CITY
EMAIL sQ-\
STATE VL zip code
PHONE #
t C <5 VSr>
AGENT INFORMATION
v^.
^ecx N\Ml
NAME
ADDRESS
CITY
qoH-XV^ -^(o<b\X PHONE #
email X>
STATE ZIP CODE
Gci
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.
VC
I HEREBY CEICTIFY THAT ALL INFORMATION PROVIDED IS CORRECT: Signature of Property Owner(s)
nv(Vrt>nf\
PRINT OR TYPE NAME
-7X>ZZ^J
sySNATUI
DATEPRINT OR TYPE NAMESIGNATURE OF OWNER #2
day ofSigned and sworn before me on this j by State of
County of C\a vy C<,V
V-'TSO'Identification verified:
OS/;
^^Wv'VW Tx\sii^Oath Sworn: ^ Yes No/y jL^o Notary Signature
(o/X j ^5My Commission expires
Q
Authorization 08.05.202102 TREE REMOVAL PERMITAPPLICA
EXHIBIT C: TREE INVENTORY and SITE PLAN
|\ City of Atlantic Beach
Community Development Department
1 800 Seminole Road Atlantic Beach, FL 32233
^ (P) 904-247-5800
CLAS
v>
FOR INTERNAL OFFICE USE ONLY
SIFICATION
i5>
PERMIT#
TREE INVENTORY-Please sketch an inventory in the area below or attach a site plan showing all existing trees on the
property below that are 8" diameter at breast height (dbh) and greater. Please complete the following:
l Show the location of all trees to be preserved with"[ ]"
l Show all existing and/or proposed buildings
l Number all trees and list on EXHIBIT D: Tree Worksheet
l Show the location of all trees to be removed with an "X"
l Show the location of all trees to be relocated with an "O'
^3?¥
\ ■'sVirkA.nao-e
Co<NC'r-
Q)-sVxj VsoLkse
1 2.
o
9
75J
SCALE: 1 SQUARE =PREPARED BY;
5
02 TREE REMOVAL PERMIT APPLICATION - EXHIBIT C: Tree Inventory and Site Plan 08.05.2021
EXHIBIT D: TREE WORKSHEET
City of Atlantic Beach
Community Development Department
y 800 Seminole Road Atlantic Beach, FL 32233
(P) 904-247-5800
4
oJi^
List the species and diameter at breast height (dbh) of all trees identified on EXHIBIT C (attach additional pages as needed).
"[]"=
preserving relocating
'0"="X"=
removing
COMMENTS (for use by City Staff)SPECIESIDDBH
1 v*-X
2 y
3 IH"X
4 XvV
LI5
6 X
^Cv.V'TYN7 X
X8
IS''9
pa\y>-v Cl10VM
ipaVv^C]i11M
12
13
14
15
16
17
18
19
20
21
22
23
24
25
02 TREE REMOVAL PERMIT APPLICATION - EXHIBITD: Tree Worksheet 08.05.2021