Pod Reg 175 Magnolia JUN-21-2013 09:36 FROM: TO:2475845 P.2/2
rs,
Y40
City of Atlantic Beach • 800 Seminole Road •Atlantic Beach.Florida 32233-5445
Phnne: (404)247-5800 • PAX (904)247-59W• http://Www/ci.atlantic-beach.fl.us
S_9q�r
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, Mood,or
other such property loss, this period of time may he extended to ten(10) days upon request to and written approval
of the City Manager. Within all non-►�esidcntial Zoring Districts,ertCloscd portable storage structures may be used
for temporary storage of items related to the busines; located on the property, for a period not to exceed thirty(30)
days. Such stiuctures cannot be located within front yard setbacks and shall not be used to store any chemical,
hazardous,flaaunable or combustible materials. DATE I ,
APPLICANT NAME: !^•t C I �
MAILING ADDRESS:
ADDRESS WHERE T +MPO Y STORAGE STRUCTURE WILL B PLACED (If different from
3 2-
mailing address.) , '
SUBDIVISION BLOCK# LOQ'#
DATES THAT THE TENgORARY STORAGE STRUCTURE WILL BE�OC�A-TED ON THE
PROPERTY: ((ss�� z I through `
effrRestdentlal property
Q Commercial (Provide survey or site plan showing location where structure will he placed.)
❑ Other - —- �0
Y fWREBY CERTIFY THAT ALL WORMATION PROVME Sgo4. a Ides Ever
Signature of property owner or authorized agent. %4-37&840
SIGNATU PRINT NAME
CONTACT INFORMATION OF PERSON SUBMrIT1NG T3US REGISTRATION FORM (PLEASE PROM
NAME
MAILING ADDRESS
PHONE FAX E" n'