195 15th St Comments (2) F" yam City of Atlantic Beach rY APPLICATION NUMBER
- � Building Department (To be assigned by the Building Department.)
rr, 800 Seminole Road /
si
Atlantic Beach, Florida 32233-5445 '
Phone (904)247-5826 • Fax(904)247-5845
,,sib` E-mail: building-dept@coab.us Date routed: 311
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �� O(:� �! De artment review required Yes No
Rijildinn
Applicant: �'7 �✓� V
pp Tree Administrator
Project: /Witt
<-70E is a ie
ublic Safety
Fire Seivices
Review fee $ Dept Signature
_ mo vi nq f�
Other Agency Review or Permit Required Review or Rece,ot Date
of Permit Verified By - ,S61)' 0 n
Florida Dept. of Environmental Protection
Florida Dept. of Transportation Qro
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants /Ia racr
Division of Alcoholic Beverages and Tobacco (,•Q.j� 1
Other: `'r�ass
I6TReAPPLICATION STATUS fJH5 IS X'161-
Reviewing
viewing Department First Review: ❑Approved. DcDenie-J..
(Circle one.) Comments: fle-est Pro�,;�L /fwd C' r10 I'�/'"h, (e^6eX /t✓"��'r
BUILDING �r-t f�►e✓n. vi, foe- PDQ" . t�le�ctG Jh04! -1401 ;14Cr e xr e-
PLANNING &ZONING
Reviewed Date: ti J
TREE ADMIN- Second Review: [-]Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. []Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09