Permit POD 444 Osprey Key 2010 OCT-25-2010 13:30 FROM: 70:2475845 P.1/1
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City or Allanllc Beach 800 Seminoles Road •Atlantic Beach, Florida 32277-5445
• Phone. (904) 247.5800 PAX (904)247.OM , http://wwwtcl.atlantle-beach.n.us
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REGISTRATION FORM
FOR TEMPORARY STORAGE STRUCTURES
Portable storegc.structures may be used within the City of Atlantic Beach following submittal of this eomplet:c
form to the Building and Zoning Department, Within all residential Zoning Districts, these may be used only fo-
the temporary storage of personal household belongings of occupants of the property and may be placed on ln::
property for a period not to exceed four (4) days or ninety-six (96) hours. Registration is required each time thv
temporary storage structure is placed on the property, In the event of damage to a residence by fire, storm, flood; or
other such property loss, this period of time may be extended to ten (10),days upon request to ilnd.writterl approve!
of the Ciry Manager. Within all non-residential Zoning Districts, enclosed portable storage structures may be used
for temporary storage of items related to the business located on the property, for a period not to exceed thirty (30!
days. Such snvctures cannot be located within front yard setbacks and shall not be used to store any chemics!
hazardous, Ilammablo or combustible materiels.
II ._ DATE_�►�" d --
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APPLICANT NAME: Onrl 4 WA G-&(!E-a
MAILING ADDRESS; .
,DDRESS WHIRE TEMPORARY STORAGE ST UCTURE WILX.BE PLACED (If different from
trlstling address.) �' Z
SUDDIviSION SG (ti�f BLOCKN LOT#
DATES THAT THE TEMPORARY STORAGE STRUCTURE WILL BE LOCATED ON TfM r
PROPERTY; /C? W r- - through
ErResldectiai property
❑ Commercial (Provide survey or site plan showing location where structure will be placed.)
[I Other 11
i 1MMY CERTIFY THAT ALL INFORMATION PROVIDE)) IS CO
Sigoalure of property owner or outborized agent. * .
S I C N ATURE PRINT hRW Moving&Statage ides Ever
CONTACT INFORMATION OF PERSON SUBMITTING THIS UGISTRATION FORM (PLIZASE PRL-'n
-NAME
MAILING ADDRESS
PHONE FAX E-MAID.