POD REG 775 PLAZA FEB-21-2014 07:45 FROM: 70:2475845 P.2/2
11(x'-. 04 4 crt /)A 5i'7Zi2..r
City of Atlantic Beach 800 Saninole Road •Atlantic Beach,Florida 32233;5445
Phone::(944)247-58.00 - VAMC (904.),247.-6605•- 1,ttp://wwwlci.atlantic.beach.n.us ,, � � .
]GISTRATION FORM / ?
FOR TEM'L I�iAR'Y STORAGE STRUCTURES
Portable storage structures may be 'd within the City of Atlantic Beach following submittal of this completed
form to the Building and Zoning L Artment. Within all residential Zoning Districts, these may be used only for
the temporary storage of personal } jsehold belongings of occupants of the property and may be placed on the
property for a period not to..exceed; tr,,,(4)'!days or.ninety-six (96) hours. Registration is required each time that a
temporary storage structure is placer, .n the property. In the event of damage to a residence by fire, storm, flood, or
other such property loss, this pario( time may be extended to ten (10)days upon.'request to a-nd-written approval
of the City Manager. Within all no 'time
Zoning Districts, enclosed portable storage structures may be used
for temporary storage of items re[at, 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 d........ . I—Zl
APPLICANT NAME:
MAILING A,DDUSS;
ADDRESS WHERE TEMPORA "TORAGE STRUCTURE WILL BE PLA ED of different from
tndlling address.) zA—SUBDIVISION BLOCK# LOT#
DATES THAT THE TEM,I'ORk
STORAGE STRUCTURE WILL BE LOCATED ON THE
PROPERTY: "/4'1 � ._through
Residential property
[� Commercial (provide survey, slte plan showing location where structure wW be placed.)
Q other
I HEREBY CERTW Y THAT ALL INFORMATION PROYMED &Stww tie.I&W
Signature of property owner or authorized agent. 94.378
SIGNATURE PRXNT NAME
CONTACT INFORMATION OF �LSON SUBIY,HTTXNG TMS REGISTRATION FORM (?LEASE Pt4n-n
NAME rrr r
MAILING A.DD^^•SY7
PHONE 4 AX