POD REG 1728 PARK TER W SEP-13-2013 15:27 FROM: T0:2475845 P.1
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City of Atlantic Bench 800 Seminole Road Atlantic Beach,Florida 32233-5445
http.,//www/cf,atiantle-beacli.tl.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 nott4:Glco dtl fgur 4 nine ty-six (96) hours. Registration is roquired each t me 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 4nd,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 chcmical,
hazardous, flammable or combustible materials.
DATE
APPLICANT NAME:
MAILING ADDRESS:
ADDRESS WHERE TEMPORARY STORAGE STRUCTURE WILL BE PLACED (If different from
lndllingaddress.)
SUBDIVISION BLOCK# LOT#
DATES THAT TBI TAMPORARY STORAGE STRUCTURE WILL BE LOCATED ON TECE
PROPERTY: --j �- through
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r�R�esideatlal property
❑ Commercial (Provide survey or site plan showing location where structure will be placed.) n _
❑ Other O
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED I °&" pR#stomp ltden Ever
Signature of property owner or authorized agent, "4-3764MS
SIGNATURE PRINT NAME
CONTACT INFORMATION OF PERSON SUBMITTING TMS REGISTRATION FORM (1PLErL5E PRRil
NAME
MAILING ADDRESS
PHONE FAX &MAIL
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