POD REG 1633 SELVA MARINA DR - POD JAN-13-2014 14: 10 FROM: T0:2475845 P.1/1
3 3,3
City of Atlantic Beach 800 Seminole Road -Atlantic Bosch,Florida 32233-5445
Phone:, (904)2474800 VAX (9,04)24748066 1 http,,/Avwwlcl.atlantie-beach.fl.us
REGISTRATION FORM
FOR TEMPORARY STORAGE STRUCTURES
Ponab)c 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
tht tttnporary storage of personal household belongings of occupants of the property and may be placed on the
property for a period not to,actedfour'(4)„days or ninety-six (96) hours. Registration is required each time that
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 rtquest to gnd•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.
APPLICANT NAME: 2— IE
MAMING ADDRESS:
ADDRESS WHERE TEMPORARY STORAGE STRUCTURE WILL BE PLACED Ctf different from
Ina ing address,) r.. ' Glc= .�MARalt-1
SUBDIVISION /=IM„ . _BL.00K# LOT#
DATES THAT TM TEMPORARY STORAGE STRUCTURE WELL BE LOCATED ON THE
PROPERTY: 1 yi 999 through —
Residential property
❑ Commercial (,Provide survey or site plan showing location where structure will be placed.)
❑ Other ...�.,.. ..—. ,, ....�._ _�_ ■
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDEV 1�a)guar
Stjjnsture of property owner or authorized agent. 794
SIGNATURE PRXNT NAME
CONTACT INFORMATION OF PERSON SUBMI'T'TING THIS REGISTRATION FORM (PLEASE P.;
tiv
NAME
MAILING �LADRESS
PHONE FAX E-MAH.