68 OCEAN BLVD POD REG. OCT-24-2013 08:33 FROM: TO:2475845 P.1/1
c -3e23,3
City of Atlantic Beach 800 Seminole Road •Atlantic Beach,Florida 32233-5445
Phone-, (904)24745800 FAX. (904)..247480+ - http://www/el.atlantic-beach.ft
REGISTRATION `ORM �,�
FOR TEMPORARY STORAGF STRUCTU S
Portable storage structures may be used within the City of Atlantic Beach following su ittal of this mpleced
form to the Building and Zoning Department. Within all residential Zoning Districts, these sed only for
the temporary storage of personal household belongings of occupants of the property and may be; placed oil thr
property for a period not to-;ex000d fow'(4):,#ys: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
ocher such property loss, this period of time may be extended to ten (10).days upon Yequest 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 rotated 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.
DATE
APPLICANT NAME:
MAILING ADDRESS:
�� W»YY��.I NN ■ �-T
ADDRESS W ME TIMORARY STORAG STRUCTURE W J. BE PLACED (if different from
1n0log address.) , l-E- -�Vc &0� . . 2—
SUBDIVISION BLOCK# LOT#
DATES THAT TIM TEMPORARY STORAGE STRUCTURE WELL BE LOCATED ON THE
PROPERTY: W 2 If— 29= W through
Resideatial property
❑ Commercial (Provide survey or site plan showing location where structure will be placed.)
❑ Other
I HEREBY CERTIFY THAT ALL WORMATION PR.OVIDA StMP Idea Iver
Signature of property owner or authorized agent. 904-378. 5
SIGNATURE 1?RXNT NAME
CONTACT INFORMATION OF PERSON SUBMITTING TMS REGISTRATION FORM (PLEASE rtu."-n
NA.MF
MAILING ADDRESS
PHO NT FAX E-MAIL