Permit POD 1693 Sea Oats Dri 2011 APR-5-2011 08:09 FROM: TO:2475845 P.1
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City of Atlantic Beac 1 800 5 n.riole Road Atlantic Beach,Florida 32233.5445
�e--� 4:http://www/ti.atlantic-beach,fl.us
Q I RA T;I10 FORM
FOR TEMP, RA STORAGE STRUCTURES
Portable storage structwes may be i.si d with 10 City Atlantic Beach following submittal of this completed
form to the Building and zoning Dep rTment. N ithin all residential Zoning Districts, these may be used only for
the temporary storage of personal h ehold ngings of ogcupants of the property and may be placed on the
property for a period not 96) hours. Registration is required each time that a
temporary storage structure is placed the pr , In the event of damage to a residence by fire, storm, flood, or
other such property loss, this period f ime m e extended to ten (10)days upon request to �nd-written approval
of the City Manager. Within all non ' identi Wing pistric;s, enclosed portable storage structures may be. used
for temporary storage of items relate t the b i ss located on the property, for a period not to exceed thirty (30)
days. Such structures cannot be loc 't d with ont yard setbacks and shall not be used to store any chemical,
hazardous, flammable or combustible terials
J� D'ATE .S� I�iLQ fr
APPLICANT NAME: p
MAILING ADDRESS:
ADDRESS ARE TEMPORAR TO STRUCTLW WILL,BE PLACED .(If different from
tniiling address,) /a1a
SUBDIVISION
BLOCK# LOT#
DA'T'ES TRAT THE TEMPORARY ORA STRUCTURE WILL BE LOCATED ON TDE
PROPERTY:
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ee- csideatial property
[] Commercial (Provide survey or,s a plan h wing 1'ocatio� where structure will be placed.)
Q Other
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I Id"EREBY CERTIFY THAT ALL 10 4RlvX ON P1Et0 VIDE T&storage Ides Jgv
Signature of property owner or auth r ed sige it 904-378 44$5
SIGNATURE i PAMT NAME
CONTACT INFORMATION OF PE ON S ITTING TICS REGISTRATION FORM (PLEASE PR.Q T)
N ANTE
MAILING ADDRESS
P140NE F _ i E-MARL,
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