CE 730 TRITON RD SEP-30-2013 08:59 FROM: TO:2475845 P.1
City of Atlantic Beach 800 Seminole Road Atlantic Beach,Florida 32233-5445
Phone•:::(904):2,41,4810—!:FAXI(904)..;24?.-5 Q6 , http;J/www/el.atlun91e-beach-fl.us
REGISTRATION FORM
FOR TEMPORARY STORAGE STRUCTURES ' .
Portable storage structures may be used within the City of Atlantic Beach following submittal of this comple(ed
form to the Building and Zoning Depa*ment. Within all residential Zoning Districts, these may be used only for
the temporary storage of personal 12us6hold belongings of occupants of the property and may be placed on the
property for a period not to exceed',!6;u ;;(h��:wdays or'pi:Aety-six (96) hours. Registration is required each ti= tltbt a
temporary storage structure is paced do the property. In the event of damage to a residence by fire, storm, flood, or
other such property loss, this peri�d of time may be extended to ten (10).days upon-raquest to knd•written approval
of the City Manager. Within'all tion•r%sidential Zoning Districts, enclosed portable storage structures may be used
for temporary storage of items rclated•Co 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 combu:ible!materials:
DATE
APPLICANTNAME.-
MAILING A )DRESS:
ADDRESS WHERE TEMPORAR:'STORAGE STRUCTURE WILL BE PLACED (If different from
inAlling address.) 7 (, T' C9'1IZ6 212
SLMI)IYISTON - ` BLOCK# LOT#
DATES THAT TIS TEMPOI3MYStORAGE STRUCTURE WILL BE LOCATED ON THE
PROPERTY; " ..�„�• through
esldential property
CJ Commercial (Provide survey or 0#te-,plt4n showing location where structure will be placed.)
❑ Other
I HER1✓13Y CERTIFY THAT ALL1";1! tMATION PROVIDED IS "WJ62 A StarW Ides Ever
Signature of property owner or atttbirizetl agent. W4-37"45
SIGNATM PRINT NAME
CONTACT INFORMATION OF PERSON SIMMITTING THIS REGISTRATXON FORM (PLEASEPMT)
NAME
!MAILING ADDRESS ;
PRONE FAX E-MAIL