CE 341 SARGO RD (2) SEP-26-2013 09:12 FROM: TO:2475945 P.1
p
3 -3,3
y •
,
City of Atlande Beach 800 Seminole Road -Atlantic Beach,Florida 32233-5445
Phoaxc�(90d) q,7 5800... ..FA "(9.Q4�,..Z47,. 95http;//www/cl.atlantic-be2ch.A.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
properry for a period not to.=ecd:f6tir"(4; ays�flr niztety-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 Are, storm, flood, or
other such property loss, this period of time may be extended to to (10).days upon i•aquest to knd-written approval
of the City Manager. Within all non-residential Zoning Districts, onelosed 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.
ATE e,->6�-
I ■.Y I Iy.�1
APPLICANT NAME! A6- /t et
MAJLING ADDRESS:
ADDRESS Wiuz,'RE4 ,OR�X STORAGE STRUCTURE WILL BE PLACED (If different from
tndill�ng address,) _D A10 2-3
�I
SUBDIVISION_ BLOCK 9, ,LOT#
DATES THAT THE TEMPORARY STORAGE STRUCTURE WILL BE LO� CATL�D ON THE
P124PERTY: f9,; .I.I.ST !.. ,,.Y.I I through `/J
MI.Y.. ;� 1 WW /
Resideatial property
Q Corumercial (Provide survey or site plan showing location where structure will be placed.)
Q Other
='qj:�
I HEREBY CERTIFY THAT ALL INFORMATION PRO 'W "Idea Z
Signature of property owner or authorized agent. "4-378-845 Z,
SIGNATURE
PRINT NAME
CONTACT INFORMATION OF PERSON SUBMITTING THIS REGISTRATION FJ!;? 11(PLEASE PR.t T)
NAME
MAILING ADDRESS
. ....,.IIS_ ...
PHONE: FAX E-MAJL