130 POINSETTIA POD REG AUG-14-2013 07:34 FROM:
T0:2475845 P.1
3 3,3
City of Atlantic Beach 800 Seminole Road •Atlantic Beach,Florida 33233-5445
Ph:o,rsec,(9040:Zd.7:-5800:,,,FAX'(9:0'4),247-6805 http.//www/ti.atlantic-bcach.ft-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"fpm'(4)"di"'`or'nirtaty-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 residenco by fire, storm, flood, or
other such property loss, this period of time may be extended to ten (10) days upon„rtquest to >tnd`written approval
of the Cary Manager. Within all non-residential Zoning Districts, enclosed portable storage structures may be used
Cor 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. 3
DATE / � " �"(�'' /
/
APPLICANT NAME: , /a A-01A I
MAILING ADDRESS:
ADDRESS WIMRE TEMPORARY STORAGE STRUCTURE WILL DE PLACED (If different from
indUing address.) „f�D r e& 4 ST „3223
SUBnrVISION BLOCK# LOTS#
DATES THAT TIME TEMPORARY STORAGE STRUCTURE WILL BE§Ot�,�TrED ON TB:E
PROPERTY; g--l� through �/l! ��jj
Residentlal property
Q Commercial (Provide survey or site plan showing location where structure will be placed.)
❑ Other • d —f-
I HEREBY CERTIFY THAT ALL XNF RMATION S'RVXDED &Slorw 14"R"W
Signature 6?pr erty owner or a or d agent. 904-378"84M
SIGNAT NAME
CONTA INF RMATION OF PE SONS MI MS REGISTRA'T'ION FORM (PLEASE Prt.tr;r)
NAME
MAILING ,ADDRESS
PHONE FAX E-MAEL
AUG-12-2013 08:23 FROM: 70:2475845 P.1 ,
a
. � 3 .,3 i.
City or Atlantle Beach 800 Semincla Road Atlantic Beach,Florida 32233-$445
http://WWW/Cl.atl2ntle-beach-l.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 wcxc'ercl"fpiu{4�'d'ays oenincty-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 fuc, storm, flood, or
other such property loss, this period of time may be extended to ten (10),days upon�request to ljnd-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 comb stible materials.
HATE .... -.,.-
APPLICANT NAME: Aroli
MAILING ADDRESS:
ADDRESS WBXRE TEMPOPARY STORA E STRUCTURE W L BE PLACED (If differ nt from
tndlling address,) ,e- 3 22J2
'"
SUBDIVISION BLOCK# LOT#
DATES THAT T]-TE TEMPORARY STORAGE STRUCTURE WML BE LOCATED ON T
PROPERTY, 't, ...� _...�through
Residential property
❑ Commercial (Provide survey or site plan showing location where structure will be placed.)
❑ Other
I HER9BY CERTIFY TRAT ALL INia'ORMATION PROVIDED IS CORRECT.
Signature of property owner or authorized agent.
SIGNATURE PRXNT NAME
CONTACT INFORMATION;OF PERSON SUBMITTING THIS REGISTRATION FORM LEASE PRD;I)
NAME
MAILING ADDRESS
PHONE l"A}C E-MAZI.