CE 1896 BEACH AVE 2015 MAY-29-2012 07:35 FROM: TO:2475845 P.1
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City of Atlantic Beach 800 Seminole Road Atlantic Bench,Florida 32233.5445
http;!/www/ci,atlnntic-beach.il.us
RJWISTRATION FORM
]'OR TEMPORARY STORAGE STRUCTURES
Portable storage structw-cs 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 96) hours. Registration is required each time that a
temporary storage shvcture 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 uponrequestto knd-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 bombustible materials, w
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APPLICANT NAME; ___5�h IJ,eo4 Y /yam f a�__
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MAILING ADDRESS;
ADDRESS WME TE MY OrY TORAGE STR CTURE WILL,BE PLACED (If different from
mailing address.) AC4/
SUBDIVISION BLOCK# LOT#
DA'rES THAT THE TEMPORARY STORAGE STRUCTURE WILL BE LOCATED ON TEM
PROPERTY; S'-- q through
Residential property y
❑ Commercial (Provide survey or site plan showing location where structure will be placed.)
❑ Other `
Y .HTREBY CERTIFY T1IAT ALL INFORMATXON PROVIDED IS CORRECT. 17
Signature of property owlter or Authorized agent.
SIGNATME PRINT NAME
CONTACT INFORMATION OF PERSON SUBMITTING TJ11S REGISTRATION FORM (PLEASE WiT)
NAME
MAILING 4DDRFSS
P I I O NE FAX The Vfflt#Wng do Storage Idea Ever
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