CE 435 Selva Lakes Cir 2012 CITY OF ATLgNTIC
CODE ENFORCEMENT tl BEACH
800 Se min DIVISION
Aantic Ole Road
Beach, Florida 32233
PHONE: 247-5855
NOTICE OFRTESY
DATE � VIOLATION
—�� TIME Q * s
OWN
ADDRESS
THE INSPECTION
THIS DATE DISCLOSED Y YOU
F THE
ORDINANCE. BOVE PREMISES
AN WERE IN VIOLATION OF
OF THE FLORIDA CODE OF THE CITY OF
ATLANTIC BEACH,
YOU CAN COMPLY BY
WITHIN
D--�
COURTESY OF THIS NOTICE
THIS IS A
YOU AWARE OF NOTICE IN ORDER
A VIOLATION OF THE CITY MAKE
OF ATLANTIC BEACH, IF
OR WOULD YOU HAVE ANY CODE
PERTAINING TIKE ADDITIONAL QUESTIONS
ATLANTIC O THIS NOTICE INFORMATION
BEACH CODE ENFORCEMENT
PLEASE CALL
` OFFICE.
CODE ENFORCE FFICER CE#
MENT O
RECEIVED By
Ly'
1
fit
City of Atlantic Beach • 800 Seminole Road •Atlantic Beach,Florida 32233-5445 i
Phone: (904)247-5855 • FAX (904)247-5845 www.coab.us
REGISTRATION FORM
FOR TEMPORARY STORAGE STRUCTURES
Portable storage structures may be used within the City of Atlantic Beach following submittal of this completed
form to the Building and Zoning Department. Within all residential Zoning Districts, these may be used only for
the temporary storage of personal household belongings of occupants of the property and may be placed on the
property for a period not to exceed four (4) days or ninety-six (96) hours. Registration is required each time that a
temporary storage structure is placed on the property. 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 structures cannot be located within front yard setbacks and shall not be
used to store any chemical, hazardous, flammable or combustible materials. I? r(
DATE 1
APPLICANT NAME:
MAILING ADDRESS: ��� ud-" �i J C-t � �Z 3
ADDRESS WHERE TEMPORARY STORAGE STRUCTURE WILL BE PLACED (If different from
mailing address)
SUBDIVISION BLOCK# LOT#
DATES THAT THE TEMPORARY STORAGE STRUCTURE WILL BE LOCATED ON THE
PROPERTY: —through- K
I�)
Residential property
❑ Commercial (Provide survey or site plan showing location where structure will be placed.)
❑ Other
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT.
Signature of property owner or authorized agent.
I _G t
r I
SIGNATURE CkA .� � PRINT NAME
CONTACT INFORMATION OF PERSON SUBMITTING THIS REGISTRATION FORM (PLEASE PRINT)
NAME
MAILING ADDRESS
PHONE 7C4–—2'1�_/ ` 4P 18 (d FAX E-MAIL
Revised May 2012