Untitled (3) YJJ f"' CITY OF ATLAN'T'IC BEACH
FENCE PERMIT APPLICATI®N
_VT 3is) Date:
PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION.
Job Address:
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Owner's Name:
Address:j�
(` Phone:
Legal Description: `Block Number: Lot Number: Zoning District:
Fence Contractor: J
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Address: ,Phone: Y�
City: State: - Zip: Fax:
f I I F J-r --r-y Type of fence and materials to be used: /
Valuation Of Fence: 4 5P.0 AQ ❑Interior Lot <YJ Corner Lot
/\ ❑Dempster or storage tank enclosure
#1 1
Is approval of Homeowner's Association or other private entity required? If yes,please submit with this application.
Tree Protection: NO. Applicant certifies that no trees will be removed for the installation of this fence.
S. Removal of Protected Trees will be required for this fence. TREE REMOVAL PERMIT IS
REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which
meets two times each month.
Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate.
Incomplete applications may result in delay in issuance of permit.
1. Attach copy of property survey showing location, height and all distances from property lines of the proposed
fence. (Fences shall not be placed within any utility or drainage easements without written permission from the
Utility and/or Public Works Departments. Fences shall not restrict any private easement.)
Address and contact information of person to .'va-&-cmespondence regarding this application(please print).
Name: PA (I j -_ — '
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Mailing Address: AP64
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Phone: Fax: E-Mail:
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800 • Fax: (904)247-5845 - http://www.ei.atlantic-beach.fl.us
Page 1 Revised 3/04/04