398 11th Street 15-DRTV-1001TREE & VEGETATION REMOVAL PERMIT APPLICATION
INSTRUCTIONS
(1) Complete and sign this form.
(2) Attach the required supporting exhibits as listed on the application
checklist.
(3) Contact the Department of Community Development if you have
questions or need assistance completing the application or
determining which exhibits are required for your particular project.
(4) Submit this form, along with all required exhibits and payment to
the City of Atlantic Beach, and in the appropriate amount according
to the application fees listed to the right, to the reception desk at
the Building Department.
ty of Atlantic Beach
' ',epartment of Community Development
-i X00 Seminole Road Atlantic Beach, FL 32233
'P) 904 247-5800 (F) 904 247-5845
F_ Single-, fwo-Family Residential $125.00
F Multi-F,�,nily Residential $250.00
F_ Comm , Fal / Industrial $250.00
F Institutional /Other Non-residential $250.00
Application # TREEIS M -T V
-�7"
SECTION I - SITE INFORMATION 1
PHYSICAL ADDRESS 3 1 rI J,3 ?zz 3�j
If on address has not been assigned to this property, contact the AB Building Department at (904) 247-5826 to request an address.
SUBDIVISION A BLOCK J LOT 7 RE#
1 SECTION 11- APPLICANT INFORMATION OWNER r LEGAL AUTHORIZED AGENT
I
NAME OF APPLICANT LINd��'`� 7KZ,�t t) -+ Icil
9 ADDRESS OF APPLICANT 4G S & �� J hid (j7t�rt{�; : �Q��( 3Z2toia
PHONE CELL q0J-;34_ 7l 'ft EMAIL
I
SECTION III - TREE & VEGETATION REMOVAL REQUEST
! I REQUEST THAT THE TREES & VEGETATION ON THE ABOVE DESCRIBED PROPERTY AND INDICATED ON THE ATTACHED REQUIRED
EXHIBITS BE APPROVED FOR REMOVAL, AS PROVIDED IN THE CITY OF ATLANTIC BEACH VEGETATION CODE, CHAPTER 23, FOR THE
FOLLOWING REASONS (check all that apply):
j r Vegetation (trees) are difficult to maintain /owner dislikes.
c
F- Trees are dead, diseased or so weakened by age, storm, fire, or other injury so as to pose a danger to persons, property,
improvements or other trees.
4
F- Vegetation (trees) pose a safety hazard to pedestrian or vehicular traffic or cause disruption to public utility services.
Vegetation (trees) pose a safety hazard to buildings or structures.
j— Vegetation (trees) completely prevent access or cross access to a lot or parcel. i
Vegetation and/or trees prevent development or physical use. It is the intent of this prevision that a permit shall be granted for
the removal of vegetation and/or trees when the applicant has demonstrated an effor i- to design or locate the proposed '
improvements so as to minimize the removal of vegetation and/or trees.
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED WITHIN THIS APPLICATION IS C:"RRECT AND I AGREE TO COMPLY
WITH ALL PROVISIONS OF CHAPTER 23, PROTECTION OF TREES AND NATURAL VEGET; ION, AND ALL OTHER APPLICABLE I
COD AND ORDINANCES OF THE CITY OF ATLANTIC BEACH.
SIGNATURE OF APPLICANT L `ATE i
A
FOR INTERNAL OFFICE USE ONLY
FRONTAGE FLU ZVAR ESA SR -1
DEPTH ZONING UEEA H/H SR -2 I
AREA ISA { ;!41V OAS CR
Tree & Vegetation Removal Permit Application_versionoi.w.og
EXHIBIT C. TREE VEGETATION MITIGATION WORKSHEET Application # TREE _-
1 of Z EXHIBIT C Tice & Vcgetation Mitigation Worksheet_ nersionol.01.09
' EXHIBIT B. TREE & VEGETATION INVENTORY Application # TREE
For the removal of 25 trees or less associated with major development, redevelopment or renovation of or addition to single-
family or two-family structures, or the removal of 25 trees or less associated with the renovation of or addition to all other non-
residential uses, use the grid below to create a Tree & Vegetation Inventory. Note the scale on the bottom of the page. Plot the
boundaries of the subject property, as well as existing and proposed structure(s). Label all adjacent streets. Note the location of
trees to be removed with an "X". Note the location of trees to be preserved with "[ ]". Note t:e proposed location of replacement
(mitigation) trees with "0". Number all trees, whether to be removed, preserved or replaced, and list on EXHIBIT C. Tree &
Vegetation Mitigation Worksheet.
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PREPARED BY:
i
,? EXHIBIT A. LETTER OF AUTHORIZATION Application # TREE
is hereby autl�;,.,rized to act on behalf of
the owner(s) of those lands described within
the attached application, and as described in the attached deed or other such proof of ownership as may
be required by the City of Atlantic Beach in applying for a development permit.
1"V
Signature of Owner
Printed Name --
�
Mailing Address
-q61194
Phone Cell Email
Signature of Owner
Printed Name
Mailing Address
Phone Cell Email
Signed and sworn before me on this I/ day of sem , Za /N by
/.tomv
Identification verified: iv
Oath sworn: J;� Yes I— No
�y�4
WILLIAM L. POPE Notary Signature
Notary Public, State of Florida
My Comm. Expires Oct. 19,25 My Commission expires:
Commission No. EE 120745 & 71 —_
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City of Atlantic Beach
Offsite Payment Form
c
Date prepared: 01/08/15
Deposit Date: 01/08/15
Prepared by: J.WALKER
Payment Cash
Type Receipt
Code Number Description
TR 15-DRTV-1019
GL Account or
Accounts Receivable Deposit
Number Amount
112-0000-366.00-00 563.50
Revised: 04/29/09
0:\Finance\finance forms\Offsite Payments\[Offsite Payment Form -Tree Fund.xls]Tree Fund
Total Deposit
Cash
ACH
Checks
Money Orders
Total
563.50
563.50
563.50
Oper: ATLBBJA Tyne: OC Drawer:
Date: 11100/15 00 Receipt no: EiM
TR TREE MITIGATI% DONATIOld=
1.00 $5613.5:
11200003660000
15-DRTV-1019 z�3__ 4.
CK CHECK 6 563.50
Trans date: 1/08/15 Time: 16:1=
City of Atlantic Beach
Offsite Payment Form
Date prepared:
01/08/15
Deposit Date:
01/08/15
Prepared by:
J.WALKER
Payment Cash
GL Account or
Type Receipt
Accounts Receivable
Deposit
Code Number
Description
Number
Amount
TR
15-DRTV-1019
112-0000-366.00-00
563.50
Total Deposit
563.50
Cash
ACH
Checks 563.50
Money Orders
Total 563.50
Revised: 04/29/09
O:\Finance\finance forms\Offsite Payments\[Offsite Payment Form -Tree Fund.x[s]Tree Fund
} PAY TO THE
ORDER OF _
Lindley Tolbert Design
465 Beach Avenue
Atlantic Beach, FL 32233
(904)234-7140
of Atlantic c Beach
DOLLARS
Three and 50/100*******���**��*�*�����x���•�a�:������:���:��::,ti��•�:�:***���*�:::::�:�:��:
Five Hundred S
16 --
ATLANTIC COAST BANK
64-7171/2612
1-040
01/08/15
$ `*563.50
City of Atlantic Beach
1:2612717171: 00009115748
TREE REMOVAL PERMIT
City of Atlantic Beach
Building and Zoning Department
800 Seminole Road Atlantic Beach, Florida 32233-5445
Phone: (904) 247-5826 Fax: (904) 247-5845 _ Email: Building-Dept@coab.us
Permit: 15-DRTV-1001 Applicant: Lindley Tolbert Design
Address: 465 Beach Avenue, Atlantic Beach, FL 32233
Site Address: 398 11th Street Phone: (904) 234-7140
RE#: Not Assigned Yet Email: lindley@lindleytolbertdesign.com
TREE REMOVAL CALCULATIONS
REMOVED Oaks Others . Total
Protected Trees Removed: 47 inches 12 inches 59 inches
Mitigation Needed: 23.5 inches 6 inches 29.5 inches
Trees Removed: 47" Oak, 12" Palm
MITIGATION Oaks Others Total
Credit for Trees Preserved: 3 inches
Credit for Trees Relocated: 0 inches
Credit for Trees Planted: 12 inches 32 inches 44 inches
Total: 47 inches
Trees Preserved: 3" Plum
Trees Relocated.• None
Trees Planted: 3-4" Oaks, 4-8" Palms
ADDITIONAL MITIGATION REQUIRED
Oaks Others Total
New Trees Planted: 11.5 inches 0 inches 11.5 inches
or
Payment Into Tree Fund: $563.50 $0.00 $563.50
or
A Combination of the Above
Additional Notes: Current Tree Fund rate is $49.00 per inch. Also removing 13" Palm, 5" Pine.
pd • J tooxs2(o '45(9-3.50
Status is in accordance e City of Atlantic Beach code of ordinances in effect at the time of review.
APPROVED
DENIED ❑
1
,,Kr
my sch, TPO ADMINISTRATOR IDAfE
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TREE AND VEGETATION REGULATIONS: General Provisions
Sec. 23-30. Minimum tree requirements.
Sec. 23-31. General prohibitions.
Sec. 23-32. Tree protection during development and construction.
(a) Restrictions during construction.
(1) Placement of materials, machinery, or temporary soils. It shall be unlawful for any person(s) to cause or
allow the storage of construction materials, the use of heavy equipment or machinery, or the temporary storage of soil
deposits within the tree protection zone of any tree or group of trees to be retained.
(2) Disposal of waste materials. It shall be unlawful for any person(s) to cause or allow the disposal of waste
materials such as paint, oil, solvents, asphalt, concrete, mortar or any other material harmful to the life of a tree within
the tree protection zone of any tree or groups of trees, or where planting beds are to be situated.
(b) Burden of tree protection on property owner. The property owner(s) and their agent(s) shall ensure that any tree
shown on the vegetation inventory for which a tree removal permit has not been obtained is to be protected. The property
owner shall guarantee survival of retained trees and replacement trees for three (3) years from the date the city accepts the
trees and landscaping as complete, unless a greater time period is required by a development order. If a retained or
replacement tree dies during that time period, the property owner shall replace the tree in accordance with a remedial
action as required by this chapter.
(c) Protective barriers and signage required. Protective barriers and signage shall be installed around every tree or
group of trees to be preserved prior to commencement of construction, in compliance with the guidelines in the Tree
Protection Guide for Builders and Developers, published by the Florida Division of Forestry and/or any other reasonable
requirements deemed appropriate by the administrator to implement this part.
(1) Temporary protective barriers shall be placed at least six (6) feet from the base of any tree, and shall
encompass at least fifty (50) percent of the area under the dripline of any tree or trees to be preserved or retained for
mitigation credit, unless otherwise approved by the administrator.
(2) Temporary protective barriers shall be at least three (3) feet high, and shall consist of either a wood fence
with two-by-four posts placed a maximum of eight (8) feet apart with a two-by-four minimum top rail, or a mesh
fence, or other similar barrier which will limit access to the protected area, unless otherwise approved by the
administrator.
(3) Waterproof, rigid sign(s) shall be affixed to each individual barricade, such that there is one (1) sign every
fifteen (15) feet along the length of the barricade. The signs shall contain the following words, and will be made
available by the city at the time of permit issuance:
(d) Adjacent properties. The property owner(s) or their agent(s) shall ensure protective barricading of all trees located
on adjacent properties, that have root or branch systems that encroach upon the subject property, and that may potentially
be impacted by development activities.
Sec. 23-33. Mitigation to be assessed.
Sec. 23-34. Maintenance and monitoring requirements.
The applicant shall be responsible for maintaining the health of any replacement or relocation trees for three (3)
years from planting.
(1) Determination of success. The applicant shall determine the condition of each tree, three (3) years after the tree
was relocated or planted. This determination shall be submitted to the city for approval within thirty (30) days of being
made. Should any tree die or be in a state of decline within three (3) years of being planted or relocated, the applicant shall
be required to replace the tree within sixty (60) days of that determination. The three-year monitoring and approval period
shall begin anew whenever a tree is replacedp.If tN ar4to
rep e found4noA-ke :vijb t the endo and
monitoring period, the applicant may pay the applbpriat an e tree �n ireU e€p` ing,r�'thittiW lament
tree. If the applicant fails to replace the tree or to pay the appropriate amount into the tree fund within sixty (60) days, the
applicant shall be in viglation of this chapter.
Sec. 23-35. Elimination of undesirable species.
Sec. 23-36. Elimination of contagious diseased and pest -infested trees.
Sec. 23-37. Payment in lieu of replacement/relocation.