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POD REG 363 ATLANTIC #11 -f'�> r.11 P�I 6.e- e ?\r e L.-"0('S (� �' / 5 S 1 t � ����' ���t/f%s7C'�,G` : ► `�4'� �'�0`� �' ��'.L P f Cit of Atlantic Beach 800 Seminole Road • Atlantic Beach, Florida 32233-5445 ,f Phone: (904)247-5800 • FAX (904)247-5845 www.coab.us OCT 24 2013 By I REGISTRATION FORM -- F R TEMPORARY STORAGE STRUCTURES po a 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 to exceed four(4) days or ninety-six(96)hours. Registration is required each time that a temporary storage structure is placed on the property.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. 2 DATE APPLICANT NAME: k� ! vUo f.— e- Pr2 MAILING ADDRESS: Co3 4AM� 41C IVJ- sci� e ii ADDRESS WHERE TEMPORARY STORAGE STRUCTURE WILL BE PLACED (ifdifferentfrom mailing address) t, SUBDIVISION BLOCK # LOT# DATES THAT THE TEMPORARY STORAGE STRUCTURE WILL BE LOCATED ON THE T © _ Zs PROPERTY10V -1� Z^ �S hrough -' r' �.. �� ❑ Residential property commercial (Provide survey or site plan showing location where structure will be placed.) ❑ Other I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT. Signature of property owner or authorized agent. SIGNATURE PRINT NAME — e T� —) C CONTACT INFORMATION OF PERSON SUBMITTING THIS REGISTRATION FORM (PLEASE PRINT) NAME _ Se +1, J c)V&jo MAILING ADDRESS 363 161-4. LV�`` PHONE��/J 'r7-7 FAX E-MAIL . c �c�ro�.�• Revised May 2012 t y rt u JS QCT 1 ' 4 2413 City of Atlantic Beach 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 - FAX (904)247-5845 www.coab.us 'REGISTRATION FORM FOR TEMPORARY STORAGE STR5eK fj&jhv Portable storage structures may be used within the City of Atlantic Beach form to the Building and Zoning Department. Within all residential Zonin y L` the temporary storage of personal household belongings of occupants of 1 p g property for a period not to exceed four(4) days or ninety-six(96)hours. '. temporary storage structure is placed on the property. Within all non-reside.; storageg structures may be used for temporary storage of items related to the period not to exceed thirty (30) days. Such structures cannot be located wi used to store any chemical,hazardous,flammable or combustible materials. tDATE APPLICANT NAME: MAILING ADDRESS: _ G kc-SA-11 ADDRESS WHERE TEMPORARY STORAGE STRUCTURE WILL BE PLACED (If different from mailing address) L SUBDIVISION BLOCK# LOT# DATES THAT THE TEMPORARY STORAGE STRUCTURE WILL BE LOCATED ON THE PROPERTY: �!dlr. 1 through ❑ Residential property To'Commercial (Provide survey or site plan showing location where structure will be placed.) ❑ Other I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT. Signature of property owner or authorized agent. SIGNATURE _ PRINT NAME T To W CONTACT INFORMATION OF PERSON SUBMITTING THIS REGISTRATION FORM (PLEASE PRINT) NAMES MAIL DRESS SIS P NE 7 7—' c FAX E-MAIL Se 44 - 1 o�Br/t AP 4Jtas ca Revised May 20 �L�Ae X I 'K-