2235 Oceanforest Dr. W. Pod Reg JUN-21-2013 09:35 FROM: TO:2475845 P.1/2
City of Atlantic Beach 800 Seminole Road -Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800 FAX (904)247-SSW- http:i/www/el.atl2ntle-beach.fl.us
REGISTRATION FORM fro
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 cannot be looatcd within front yard setbacks and shall not be used to store any chemical,
hazardous, flammable or combustible materials. '
DATE �� �-�G/1 e--�. -
APPLICANT NAME: If— d:n n,
MAILING ADDRESS:
ADDRESS WHERE TEMPORARY STORAGE STRUCTURE WILL BE PLACED (If different from
enailing address.) 2 fdC °G4-1 /Cw.", 5i 4a.6::: .,. ge=j iii. . .,
StrriDrvlsroN df� � .[.� BLOCK 0 LOt
DATES THAT THE TE ORARY STORAGE STRUCTURE WILL BE LO1CATE4t N THE
PROPERTY: '�--( through C
ec denttal property
❑ Commercial (Provide survey or site plan showing location where structure will be laced.)
❑ Other
I HEREBY CERTWY THAT ALL INFORMATION PROVIDE. StorW Idea Ever
Signature of property owner or authorized agent.
`� -mss
SIGNATURE PRINT NAME _
CONTACT INFORMATION OF PERSON SUBMITTING TMS REGISTRATION FORM (PLRASL PYt U%M
NAME
MAILING ADDRESS
PHONE FAX E-MAIL