1830 Ocean Grove Dr TREE23-0055 12.06.2023 SCHifi TREE REMOVAL PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
s City of Atlantic Beach CLASSIFICATION1r4CommunityDevelopmentDepartment
800 Seminole Road Atlantic Beach, FL 32233 PERMIT#
0;1tj%- (P) 904-247- 5800
PERMIT FEES
Single-/Two-Family Residential $125.00
PERMIT REQUIRED FOR REMOVAL !I',.(+84,:'• lig,Multi-Family Residential 250.00
OF TREES 8 INCHES DIAMETER AT
1rc
Commercial/Industrial 250.00
BREAST HEIGHT AND GREATER 1 F-
jI(
Institutional/Other Non-Residential $250.00
SITE INFORMATION
ADDRESS i8U 30 OCnecty, &rove V 3 9-4 6 6
APPLICANT INFORMATION
NAME C 4 L. L-Ui.J sem,pe- r^G OWNER LEGAL AUTHORIZED AGENT
ADDRESS 16 01 C 0 uvti 1 5i CITY JeAI STATE Fl— ZIP CODE 3d,2001
PHONE# 90o - 33i-4 — 5-iO7 EMAIL G)Sw• i Jre II u ne1.5c-ctp c ,corn
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 ofWarranty Deed that verifies record of owner
EXHIBIT B(Option 2)-LETTER OF AUTHORIZATION: Please complete ifthe 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
ORDINANCES OF THE CITY OF ATLANTIC BEACH.
9t1(TUR-E DrOWNEl'or AGENT PRINT ORVIDE NAME DATE
Signed and sworn before me on this cIt day of III c'1'r-lh,' st),9,3 by State of Iiari,Cte`
County of TCs\(n t
Identification verified:
f ow-. _war 1
Oath Sworn: Yes o;•,"a,'•. MARILYN MACARAGES 9_
0. '. MY COMMISSION#GG 982930 a.-;)l.1-4,4Z ` 6-P.y A f`—"NotarySignature 0v_',.EXPIRES:July 13,2024 g
ori°°' Bonded Toru Notary Public Underwriters ttuMyCommissionexpires 'JL 1 131,c2eA
02 TREEREMOVAL PERMIT APPLICATION 01. 31.2023
ROW23-0044
rs,..„,, ;,, EXHIBIT A: TREE PERMITTING PROCESS
S$ City of Atlantic Beach
to Community Development DepartmentJyr800SeminoleRoadAtlanticBeach, FL 32233
1.09'' (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.
Ifthere 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 prior to 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
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 permit is finaled.
C_ 11111.1 Geo icre_ cA,,\>LN
SI 'TURE OF APPLICANT PRINT OR TYPE/NAME DATE
02 TREEREMOVAL PERMIT APPLICATION-EXHIBIT A:TreePermitting Process 01.31.2023
RIGHT-OF-WAY/EASEMENT PERMIT APPLICATION ALL INFORMATION
72;. City of Atlantic Beach HIGHLIGHTED IN GRAY IS
800 Seminole Road, Atlantic Beach,FL 32233 REQUIRED.
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBIAINING UTILITY LOCATES
Address :30 e , , _ .Permit Number gt k).n` UD—ILI
Contractor Information
Company C*Z lya, 4501i,y. Qualifying Agent e. / X372
Address /‘‘PV sf Ar'i City ,aat State r4Zip 3 22c72._
Phonefb454–33 4 - / 7Email C'-1S M 1 H C LLf3y)catcc •Cor•-,
State Certification/Registration #
Architect Phone Email
Engineer Phone Email
Workers Compensation Insurers OR Exempt Expiration Date
Permittee declares that prior to filing this application they have ascertained the location of all existing utilities,both aerial
and underground and the accurate locations are shown on the sketches.
Whenever necessaryfor the construction,repair,improvement,maintenance,safe and efficientoperation,alteration or
relocation ofall,or any portion of said street or easement as determined by the Public Works Director,any or all said poles,
wires,pipes,cables or other facilities and appurtenances authorized hereunder,shall be immediately removed from said
street or easement orreset or relocated hereon as required by the Public WorksDirector and at theexpenseof the
Permittee unless reimbursement is authorized.
All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the
supervision of -'eOR al/ Nrje• Project Superintendent)
with(Company Name) 4 d5 iA Phone 0 '
All materials and equipment shallbe subject to inspection by the Public Works Director.
Allcity propertyshallbe restored to itsoriginal condition as far as practical,in keepingwith City specifications and the
manner satisfactory to the City.
A sketch of plans covering details ofthis installation,as well as a copy of a recent survey shall be made a part of this permit.
Calculations showing any increase in impervious area on owner's lot or in the City right-of-way are to be included with
this application.
The permittee shall commence actual construction in good faith within days. If the beginning date is more than 60
days from date of permit approval then permittee must review the permit with the Public Works Director to make sure no
changes have occurred in the area that would affect the permitted construction.
It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right,
title and interest in the land to be entered upon and used bythe holder,and the holder will,at all times,assume all risk of
and indemnify,defend and save harmless the City of Atlantic Beach from and against any and all loss,damage and cost of
expenses ansin i erofthe exercise orattemptedexercises bythe holder oftheaforesaid rights and privileges.
Th 'c is Director shall a notified 24hours priorto starting work and again immediately uponcompletion.
Date Ii 1 Aq}„1)
Permigned in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this 40 day of .N'o V e,*1,Nbii 7 20 •)2
by G 7-'. 5vw. tile. whopersonally appeared before me and
l printed name of Permittee)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed In It. N., MARILYN MACAMGES
sMY COMMISSION 0GG 42130
EXPIRES:July 13,2024
u''` L__i/14 _,( )41 tit J V? IZ personally Kn n`••.••,• .• RrMVendedTNryNotary CUnderwrbrs
Signature of Notar'Public,State of Florida 0 I IProduced Iden 'cation(Type:_______-_—
H:\Appi'catans&Forms1Word Documents\201801001 Right of WayEasement Permit AppLcauon.doot Revision Date:10/1/1S
EXHIBIT B: LETTER OF AUTHORIZATION
City of Atlantic Beach
CommunityDevelopment Department
800 Seminole Road Atlantic Beach, FL 32233
2> (P) 904-247-5800
Please complete if applicant is not the owner
OWNER INFORMATION
q'JNAMECre/0 73 $ tfQr\ PHONE# 9P - 9 I - 16 1f
ADDRESS 10 36) DC eGt r G co c_ 1/r EMAIL A AL Ayr()V 6015„,,' int4
CITY vac-45oriv C STATE FL ZIP CODE 3 d'a66
AGENT INFORMATION
NAME C 4 L 0 hC PHONE# 960 - 3 3 - 5-I6-7
ADDRESS ( 6O ( E oul,6. 1 51- EMAIL 9 sW^r—v roc 11-4-1Jscope,oat
CITY To1/4.)C STATE f- I.- ZIP CODE 36zolo a
G4 L Lund S t.ckpe 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,foran application relatedto aTree and Vegetation Removal Permit.
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT:Signature ofProperty Owner(s)
1r /al/a 3 _
SIGN RE OF OWNER PRINT OR TYPE NAME DATE
SIGNATURE OF OWNER#2 PRINT OR TYPE NAME DATE
Signed and sworn before me on this 1 day of nt 1i'v-r h 7 t ? by State of no(t
County of 1)01.1l -1
Identification verified:
Oath Sworn: YesG " MARILYN MACARAGES... ,.
r•. 1.1 MY COMMISSION#GG 982930 11,.
l'.%__mac' EXPIRES:July 13,2024 Notary Signature
Bonded Tnru Notary Public Undeiwrgoq
moi r.
1MyCommissionexpires `f k.lt( i g?C
02 TREE REMOVAL PERMIT APPLICATION-EXHIBIT B:Letter of Authorization 01.31.2023