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CE 72 W 11TH ST 2012 General Contractors, Inc. A`l. J t� 248 Levy Rd. •PO.Box 330775 SIKE 1987 Atlantic Beach,Ft 32233 (904)241.4416.(904)241-4427 E,x pete@rpcgc.com/rpcgc@rpcgc.com Pefe Rodrigues - Presidenf City of Atlantic Beach 800 Seminole Road •Atlantic I Visit our website at www.rpcgc.com Phone: (904)247-5800 FAX (904)247-5805 • http://www/ei.atiantic-lit:n,-......-- REGISTRATION FORM FOR TEMPORARY STORAGE STRUCTURES Portable 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 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. 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 request to and 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. DATE Z' -7 - 1'2- APPLICANT NAME: PF'-rop— J �y J ES MAILING ADDRESS: 3 g C, l i S',r>�- ,4 1�s ADDRESS WHERE TEMPORARY STORAGESTRUCTURE WILL BE PLACED (If different from mailing address.) 3({ (s � SUBDIVISION BLOCK# LOT# DATES THAT THE TEMPORARY STORAGE STRUCTURE WILL BE LOCATED ON THE PROPERTY: Z ^ l 3 ) 'Z through - . / 2 Residential property ❑ Commercial (Provide survey or site plan showing location where structure will be placed.) ❑ Other I HEREBY CERT7yT4U1bT ALL INFORMATION PROVIDED IS CORRECT. Signature of propert owne or authorized agent. SIGNATURE PRINT NAME CONTACT INFO SON SUBMITTING THIS REGISTRATION FORM (PLEASE PRINT) NAME MAILING ADDRESS PHONE FAX E-MAIL