West Plaza Extension (Lily St)_2008-03-12 TREE &VEGETATION REMOVAL APPLICATION
PART I — REGISTRATION
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City of Atlantic Beach � � �_ ,
07
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Lepartrnent of Planning&Zoning
_ 800'Seminole Road Atlantic Beach FL 32233
(P)904*47-5826 (F)904 247-5845 PERMIT#
SECTION I—PROPERTY OWNER INFORMATION
NAME OF OWNER(S) A
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Aw
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DRESS OF OWNER(S) ► _,s .. .'
PHONE CELL EMAIL '
SECTION 11—CONTRACTOR INFORMATION
NAME OF CONTRACTOR
NAME OF COMPANY
ADDRESS OF COMPANYee A, Ll !
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VA.1-1 o
PHONE CEL - EMAIL .
CONTRACTOR CERTIFICATION NUMBER
ATLBCH BUSINESS TAX RECEIPT NUMBER
SECTION III-SITE INFORMATION
7'STREET ADDRESS OF PROPERTY - :[ ,��� � =_ ,�
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if an address has not been assigned to this property,contact the AB Building Department at(904)247-5826 to request an address.
LEGAL DESCRIPTION Lvf!LT_ /)hiv
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LOT BLOCK SUBDIVISION
REAL ESTATE NUMBER LOT OR PARCEL SIZE: SQ FT AC
RESIDENTIAL COMMERCIAL OTHER(SPECIFY)
HAS THIS SITE BEEN BEFORE THE TREE CONSERVATION BOARD PREVIOUSLY? ~¢
NO F NOT SURE F YES
HAS THIS SITE BEEN REVIEWED BY PUBLIC WORKS DIRECTOR FOR ON-SITE STORMWATER RETENTION? F-- NO r NOT SURE YES
DOES SITE DIRECTLY ABUT JURISDICTIONAL WETLAND CONSERVATION AREAS}? �< NO NOT SURE F_ YES
page 1 sof 5 ��
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SECTION IV-REQUESTED ACTION PERMIT#
UNDERSTORY VEGETATION REMOVAL AUTHORIZATION
I CERTIFY THAT ONLY UNDERSTORY VEGETATION ON THE ABOVE DESCRIBED PROPERTY AND INDICATED ON THE ATTACHED
EXHIBITS WILL BE REMOVED FROM SAID PROPERTY. (PLEASE ATTACH REQUIRED EXHIBITS A, B, C, D,AND H,AS DESCRIBED
BELOW)
TREE'REMO►VAL AUTHORIZATION
I REQUEST THAT TREES DESCRIBED ON THE ATTACHED "TREE REMOVAL AUTHORIZATION" FORM AND INDICATED ON THE
ATTACHED EXHIBITS BE APPROVED FOR REMOVAL UTILIZING THE ATTACHED FREE REMOVAL AUTHORIZATION FORM AS
PROVIDED IN THE CITY OF ATLANTIC BEACH TREE PROTECTION CGDE, CHAPTER 23, ARTICLE 11. (PLEASE ATTACH REQUIRED
EXHIBITS A,B,C,D,G,AND H,AS DESCRIBED BELOW)
TREE REMOVAL EXEMPTION
I CERTIFY THAT TREES INDICATED ON THE ATTACHED EXHIBITS ARE EXEMPT FROM TREE REMOVAL AUTHORIZATION AND
MITIGATION REQUIREMENTS AS PROVIDED BY THE CITY OF ATLANTIC'BEACH TREE PROTECTION CODE,CHAPTER 23,ARTICLE 11.
(PLEASE ATTACH EXHIBITS A,B,C,AND D,AS DESCRIBED BELOW)
TREE PRESERVATION
I CERTIFY THAT TREES LOCATED ON THE ABOVE DESCRIBED PROPERTY AND INDICATED ON THE ATTACHED EXHIBITS ARE TO
BE PRESERVEDIPROTECTED IN LIEU OF MITIGATION REQUIREMENTS AND ACCORDING TO THE METHODS SET FORTH IN THE
CITY OF ATLANTIC BEACH TREE PROTECTION CODE,CHAPTER 23,ARTICLE 11. (PLEASE ATTACH REQUIRED EXHIBITS F AND H,AS
DESCRIBED BELOW)
NO TREE AFFIDAVIT
I CERTIFY THAT THERE ARE NO PROTECTED TREES LOCATED ON THE ABOVE DESCRIBED PROPERTY. (PLEASE ATTACH REQUIRED
EXHIBITS B AND C,AS DESCRIBED BELOM
SIGNATURE.OF OWNER SIGNATURE OF GINNER
State of Florida
Signed and sworn before nye on this day of ,by County of Duval
Identification verified:
Oathsworn:
Yes No
Notary Signature
My Commission expires:
SECTION V-OATH
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED WITHIN THIS APPLICATION IS CORRECT AND I AGREE TO COMPLY
WITH ALL PROVISIONS OF CHAPTER 23,ARTICLE II,TREE PROTECTION,AND ALL OTHER APPLICABLE CODES AND
OR777THEr
OF ATLANTIC BEACH.
SIGNA RE F OWNER OR AtkHORIZED PERSON IF LETTER OF AUTHORIZATION IS ATTACHED DATE
SIGNATURE OF AUTHORIZED CITY OFFICIAL
DATE
page 2 of 5 ., i
INSTRUCTIONS FOR FILLING OUT A TREE&VEGETATION REMOVAL APPLICATION
1. Complete TREE&VEGETATION REMOVAL APPLICATION,PART 1-REGISTRATION(pages 1-2),or type/print clearly. Attach additional
sheets as necessary. All correspondence must be in typewritten form. All plans,drawings must be full size(24"X 36"),drawn at a scale
of one inch equals 20 feet(unless otherwise approved),and signed and sealed or certified as appropriate. Illgalbie aDDlicationLwill be
returned.
2. Complete Section I(Property Owner Information),Section 11(Contractor Information),and Section III(Site Information), Incomplete
Q _b rms will &returned.
3. Complete Section IV(Requested Action)by checking the appropriate box(es)and attach required exhibits specified above and
described below. Applications with ingQmr)I ete o missing I e returned. If either"'TREE REMOVAL AUTHORIZATION or
- a exhibits will b
"TREE PRESERVATION"are checked,you must complete PART 11-PERMIT APPLICATION(pages 4-5)of this form also,and submit
appropriate exhibits,as listed above in Section IV and described below.
EXHIBIT -Description of work to be completed,including,but not limited to,the following.: understory vegetation
removal,tree removal,exotic/invasive species removal,tree relocation,clearing for development,,etc. Also include a
description of the method of tree or vegetation removal,including,specific type of machinery or equipment to be
utilized.
EXHIBIT -Warranty Deed or other proof of ownership.
EXHIBIT C-Current photographs of the property prior to vegetation removal and/or relocation. Include all sides of the
property(One(1)copy of each photograph).
EXHIBIT D-Informal site plan,or survey with existing and/or proposed structures sketched in.
EXHIBIT E-Approved final site plan.
EXHIBIT F-Approved final landscape plan.
EXHIBIT G-Tree Survey.
EXHII -Written sign-offs,permits,or consents from other jurisdictional agencies,'including,but not limited to the
following: Saint Johns River Water Management District(SJRWMD),Florida Department of Environmental Protection
(FDEP).
4. Complete Section V(Oath)with signature and date.
5. A Tree Survey(EXHIBIT G)Indicating the following must be completed and submitted if"Tree Removal Authorization"is checked.
a.ON THE SURVEY,to be reviewed by the Tree Conservation Board
I)show property lines,as well as interior/exterior zones,using setback lines of 20'front&rear and 7.5'each side.
ii)show existing and proposed structures.
iii)show location of utilities and easements as applicable.
•iv)show location,species and size of all trees with Diameter at Breast Height(DBH)of six inches(6")or more.
v)mark all existing trees to be removed from the site with an fix1f,
vi)mark all existing trees to be preserved on-site with brackets,"[ 1".
vii)mark all proposed location(s)of replacement trees with a circle,"0".
b.ON THE SITE,to be inspected by City of Atlantic Beach staff
1)display address/legal description of property in a conspicuous manner.
ii)mark property corners with stakes or paint.
iii)barricade all trees to be preserved at the tree drip line. (See Section 23-17(f)of the COAB Code of Ordinances)
iv)mark all trees Identified for removal with RED/ORANGE flagging,paint or tape.
v)mark all trees identified for preservation with BLUE/GREEN flagging,paint or tape.
c.INCOMPLETE APPLICATIONS AND/OR SURVEYS AND INCORRECTLY MARKED SITES WILL NOT BE PROCESSED.
4. Once the site has been prepared for inspection,submit two (2)copies of the completed TREE&VEGETATION REMOVAL APPLICATION,
PARTS I&11 as necessary,along with two(2)copies of the all required exhibits and any other supporting materials to the City of Atlantic
Beach Planning Department.
5. The Tree Conservation Board meets twice monthly,on the 2nd and 4th Wednesdays. Applications received by Spm on the 1 st and 3rd
Mondays of each month will be considered at the next regularly scheduled meeting,provided additional information is not required.
page 3 of 5
PERMIT#
TREE REMOVAL MITIGATION WORKSHEET
TREES PROPOSED FOR REMOVAL DIAMETER OF TREES IN INCHES* REASON FOR REMOVAL OO NOT WRITE IN THIS SPACE
SPECIES
IINTERIORZONE** EXTERIOR,ZONE* APPLICANrs COMMENTS FOR TCB USE ONLY
.A
711
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}DIAMETER AT BREAST HEIGHT(DBH)IS MEASURED AT 4.5 FEET ABOVE GRADE. TO ACCURATELY DETERMINE DIAMETER,MEASURE THE TRUNK
'CIRCUMFERENCE AND DIVIDE BY 3.14. DIAMETER OF MULTI-TRUNKED TREES IS DETERMINED BY ADDING TOGETHER THE DIAMETER OF EACH
TRUNK AS MEASURED IMMEDIATELY ABOVE THE FORKS)..
�** INTERIOR ZONE: INSIDE THE 20-FOOT FRONT/REAR SETBACKS AND THE 7.5-FOOT SIDE SETBACKS.
EXTERIOR ZONE. OUTSIDE THE 20-FOOT FRONT/REAR SETBACKS AND THE 7.5-FOOT SIDE SETBACKS.
MITIGATION REQUIREMENTS
TREE REMOVAL CAN RE MITIGATED IN THE FOLLOWING WAYS,SINGULARLY OR IN COMBINATION:
1. PROTECTION OF EXISTING TREES ON-SITE.
2. REPLACEMENT WITH NEW TREES ON-SITE.
3. PAYMENT INTO THE TREE FUND AT THE CURRENT RATE($117.00 PER INCH-2007)
NOTE: ONE(1)INCH OF MITIGATION IS REQUIRED FOR EVERY TWO(2)INCHES OF PROTECTED TREES REMOVED.
PLEASE+CHECK THE METHOD(S)OF MITIGATION THE APPLICANT/OWNER WISHES TO PURSUE.
PROTECTION OF EXISTING TREES. THESE TREES SHOULD BE NOTED ON THE SUBMITTED TREE SURVEY,MARKED BY
F_ REPLACEMENT WITH NEW TREES. THESE TREES SHOULD BE NOTED ON THE SUBMITTED TREE SURVEY,MARKED BY 11011.
PAYMENT INTO THE TREE FUND. A CHECK,PAYABLE TO THE CITY OF ATLANTIC BEACH,SHALL BE PRESENTED TO THE BUILDING
DEPARTMENT AT THE TIME OF PERMIT PICK-UP.
If replacement with trees is the chosen method of mitigation,and a Landscape Plan has not been prepared such that the replacement trees
cannot be demonstrated at the time of Tree Removal Authorization,the applicant(property owner)will have six(6)months from issue of the
Tree Removal Permit to,Produce and submit a Landscape Plan satisfactory to the Tree Conservation Board. If,after six(6)months from the
date of Tree Removal Permit issue,no such,plan has been produced and submitted,the applicant(property owner)will be presented with an
invoice in the amount equivalent to the mitigation obligation,to be paid to the City ofAtlantic Beach Tree Fund within two(a)weeks from
date of receipt, Should the applicant(property owner)fail to pay the required mitigation as directed,the case will be turned over to the Code
Enforcement Board for remedy.
Additionally,replacement trees must be in the ground,located according to the approved mitigation plan before a Certificate of Occupancy
is issued. PP
ed. Thea applicant is required to guarantee survival of replacement trees for 18 months. Should replacement trees not survive,they too
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will tiara;to ug mplowd,
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