Temp Storage 2260 Barefoot Trace 2012 ,
kone:
of Atlantic Beach • 800 Seminole Road -Atlantic Beach,Florida 32233-5445
(904)247-5800 - FAX (904)247-5805 - http://www/ci.ationtic-beach.fl.us
REGISTRATION FORM
FOR TEMPORARY STORAGE STRUCTURES
Pe able storage strucum may be ustd 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 structm is placed on the property. U the event of damage to a residence by fire,storm,flood,or
othelr such property loss,this period of time may be extended to ten(10)days upon request to and written approval
of the City Manager. Within all non-residential Zoning Districts,enclosed ' rtable storage structures may be used
for temporary storage of buns related to the business looted on the propert�,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.
DATE
APPLICAM NAME: R-
MAILING ADDRESS: Z Z0 O ,�3A }=O oT
ADDRESS WHERE TEMPORARY STORAGE STRUCTURE WILL BE PLACED (If different from
mailing address.)
SUI)DIVISION 04",,L;u,�4z-A BLOCK# LOT#
DATES THAT THE MPORARY STORAGE STRUCTURE WIJLL BE LOCAT D ON THE
PROPERTY: /Q / through
RrResidenthd property
❑ Commercial (Provide survey or site plan showing location where structure will be placed.)
❑ Other
I HEREBY CVYZf Y THAT ALL INFORMATION PROVIDED IS CCOtRECT.
Signature of property owner or authorized eat.
SIGNATURE PRINT NAME AZF-cvr,t!
COJUACT 94FORMATION PERSON SUBMffMG THIS REGISTRATION FORM ottxresz mom
NAGE
MAILING ADDRESS 2-Z-00 SA j-Er=v,::�-r '--rr44tE, A1"LAf ric hC[{. Fi.- 32-z-33
PHONE 90�'3�3 2f�9 S FAX i E-MAIL (<E�y.146LHi4A0G)S4'• &f