Permit POD 1668 W Park Terr W 2010 JUL-5-2010 10:26 FROM: 70:2475845 P.2.
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City or Atlantic Desch 80o Seminole Road Atlantic Beach, Florida 32233.5445
Phone! (904)247-5800 FAX (904)247.OM • http.,//www/cf,atientie-beaeh.n.uv
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"9ISTRATION FORM
FOR TEMPORARY STORAGE STRUCTURES '
Portable storage•structures may be used within the City of Atlentic Beach following -submittal of this complet:c
form to-the Building and Zoning Department. Within all residential Zoning Districts, these may be �sed only for
the temporary storage of personal household belongings of occupants of the property and may be 0,1aced on l�r
property for a period not to exceed four (4) days or ninety-six (96) hours, Registration is required tst h time that
temporary storage structure is plated on the property. In the event of damagt to a residence by ftre,:stgrm, flood, or
ocher such property loss, this period of time may be extended to ten (lb)days upon,request to jip °*rittert opproya!
of the City Manager. Within all non-residential Zoning Districts, enclosed portable storage structures iney 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 structures cannot be located within front yard setbacks and shall not be used to store any chemic3i
hazardous, nornmable or combustible materiels. t
c DATE_ .5+�JC/l�ir_�•O,lQ
APPLICANT NAME:
R&eh e.( S.-oal
MAILING ADDRESS:
ADDRESS WMR R T MPORARY STORAGE STRUCTURE WILL BE PLACED (If dlfferta(from
tnAding address.) '
SUBDIVISION BLOCK N_`LOTN _
DATES THAT THE TEMPORARY STORAGE STRUCTURE WILL BE LOCATED ON THE
PROPERTY: "througb 2
-0 7 esidcotlal property 2- 3 ( 1311 .
- 3 ( 131r
0 Commercial (Provide survey or site plats showing location where structure will be placed,) J�
0 Other / z6a,
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I HEREBY CERTIFY THAT ALL IN>±ORMATXON PROVIDED IS CORRECT.
Signature of property owner or authorized agent,
SIChATUR.E
PRINT NAME
CONTACT INFORMATION OF PERSON SUBivI17MG TMS REGISTRATION FORM (ri,l sic Pw-n
NAME
MAILING ADDTtESS PUUI
al
PHONE FAX cad
Jacksonville, F 32220 r