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City of Atlantic Beach • $00 Seminole Road •Atlantic Beach,Florida 32233-5445
Phone-,;(904.):247-5800. • FAX''(904).24.7-/Ji�(880 - http:/Avww/ci,itlantic-boach.fl.us
REGISTRATION FORM
FOR TEMPORARY STORAGE STRUCTURES J,
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 Wexceed.four;(4}:days: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
other such property loss, this period of time may be extended to ten (10).days upon request to ajid`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 combustible materials.
-, DATE "� C/r-
APPLICANT NAME: ( �1D 3/Z DJ
MAILING ADDRESS;
ADDRESS WHERE TEMP9YARY STORAGE STRUCT='WELL'BE PLACED (If different from
tndlling address.) P
SUBDIVISION BLOCK# LOT#
DATES TRAT THE TEMPORARY STORAGE STRUCTURE WELL BE WCA.TED ON TEE
PROPERTY: �`— Cy,c �..r.`tbrough
esldentlal property
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Q Commercial (Provide survey or site plan showing locatlon where structure will be ac
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I MEBY CERTYFY THAT ALL INFORMATION PROVM01 Stomp Ides
Signature of property owner or authorized agent. %4-378*W. k4
SIGNATURE PPJM NAME t
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CONTACT INFORMATION OF PERSON SUBMITTING TEES REGISTRATION FORM (PLEASE PRLN-n
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MAILING ADDRESS
PHONE FAX E-MAIL
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