POD REG 300 5TH ST JUPl-14-2013 03:06 FROM: T0:2475845 P.1/1
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City of Atlantic Beach 800 Seinlnolc Road Atlantic Beach,Florida 32233-5445
Phone: (904)247µS800 FAX (904)247-"- 0*- http://www/ei.atlantic-boach.fl.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. 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 and written approval
of the City 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 structures carmot be located within front yard setbacks and shall not be used to store any chemical,
hazardous,flammable or combustible materials. / /� �(e-- /
DATE / ( I
APPLICANT NAME:
MAILING ADDRESS:
ADDRESS WRFRE T,EMPORARV STORAGE STRUCTURE WILL BE PLACED (If different from
mailing address.) 57— Z
SUBDIVISION BLOCK A LOT#
DATES THAT THE TLr POR,ARY STORAGE STRUCTURE WILL BE/LOCA D ON THE
PROPERTY: . _ through r/ `
esidential property
❑ Commercial (Provide survey or site plan showing location where structure will be placed.)
❑ Other 11 s =—
A Z0
I I-1-'E�REBX CERTIFY THAT ALL INFORMATION PROVYPNOW�AIil Sl4rage Idea Ever
Signature of property owner or authorized agent. 904-379-8485
SIGNAT(II2E PRINT NAW
CONTACT INFORMATION OF PERSON SUBMITTING THIS REGISTRATION FORM (PIXAsIC PRIN71
NAME
MAILING ADDRESS
PHONE FAX E-MAIL