CE 2319 SEMINOLE RD. JUL-31-2013 07:57 FROM:
70:2475845 P.1J1
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City of Atlantic Beach • 800 Scrrdnole Road Atlantic Beach,Florida 32233-5445
'Pho,ae.=(904):247-5800 . FARC"'(9,o'd),2'd7 89�5J• • http://wwwlci.atlantle-beAch.fl,us
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REGISTRATION FORM
FOR TEMPORARY STORAGE STRUCTURES
Portable storage structures may be used within the City of Atlantic Beach following submittal of this completed
form io 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 notto: cried~#'o4iir{,4 'wcl ya�ar'rt rtcty-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 e&--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 located within front yard setbacks and shall not be used to store any chemical,
hazardous, flammable or combustible materials,
DAr iy ro/
DATE
APPLICANT NAME; /'� (}P14 5 T TO
MAILING ADDRESS:
ADDRESS WHERE TEMPORARY STORAGE STRUCTURE WILL BE PLACED (If different from
tudiling address.)
SUBDIVISION BLOCX# TOOT#
DATES THAT THE TEMPORARY STORAGE STRUCTURE WILL B LOCATED ON THE
PROPERTY: 7"3" tbrough
Residential property
❑ Commercial (Provide surveyor site plan showing location where structure will be placed.)
❑ other
11J:EREBY CERTIFY THAT ALL INTS'ORMATION PROVIDED IS C "ir&&Storrs Ida Ewer
Signature of property owner or authorized agent, 904-37"485
SIGNATURE PRTNT NAME
CONTACT INFORMATION OF PERSON SUBMITTING'THIS REGISTRATION FORM sPLFASE t•Rmr)
NAKF
MAILING ADDRESS
PHONE FAX E-MAIL w.