POD REG 1941 BEACH JUN-12-2013 16:25 FROM: TO:2475e45 P.1
City of Atlantie Reach 800 Seminole Road •Atlantic Beach,Florida 32233-5445
Phone: (904) 247-5800 FAX (904)247.586 • http:IlwwNv/ci.atiantle-beacli.fl.us
REGISTRATION FORS
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 foci
the temporary storage of personal household belongings of occupants of the property and may be placed on the'
properry for a period not to exceed four (4) days or ninety-six. (96) hours. Registration is required each time that a' ri
temporary storage structure is placed on the property. In the event of damage to a residence by fire,storm, flood, or, z
other such Property loss, this period of time may be extended to ten (10) days upon request to and written approvat
of the City Manager. Within all iron-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 combustibit materials.
DATE e, --1
APPLICANT NAME:
MAILING ADDRESS:
ADDRESS WHEREE ORAIAY STORAGE STRUCTU W)rLL BE PLACED (If different from
mailing address.) � l r� G�G�I �d� 2-2_3, --
SUBDIVISION -- BLACK# _LOT#_
DATES THAT THE TEMPORARY STORAGE STRUCTURE WELL BE LOCATED ON THF;
PROPERTY: 12— :YG't e through '� {
Residential property
❑ Commercial (Provide survey or site plan showing location where structure will be placed,) 3
❑ Other I /
I ffF> ,EBY CERTIFY THAT ALL INFORMATION PROVED Storage Idea Ever
Signature of property owner or authorized agent. 904-378-8483
SIGNATURE PRINT NAME
CONTACT INFORMA'T'ION OF,PERSON SUBMITTING TRIS REGISTRATION FORM (PLEASF PPINT)
NAME
MAJ1I<NG ADDRESS
PHONE FAX C-MA.ff, --�