125 DONNER RD - SUBDIVISION PLAN -SJJI City of Atlantic Beach ECEIVE9 APPLICATION NUMBER
r '.. i1 (To be assigned by the Building Department.)
�- . .;, Building Department
800 Seminole Road JUN 3 2016 1 (a -S. FPA- 12. 5
_.w.,','.w r' Atlantic Beach, Florida 32233-544
Phone(904)247-5826 • Fax(904 7-5845 Date routed:
r Email: building-dept@coab.us Y:
&/.. C)F-C9 .
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I 2.5 00/..-_, C4e Iri 1 Department review required Yes No
-Idin.
r) Pl &Zoning 51 . ..
Applicant: _L., l-tR l S L !- ,, SCI?T SZS k__.) Tree • • . . - •
Project: S (� t V t t o i . PLALD 4�"b is Works
,. taL7f -T4k-V111111111.11
Public Safety _
Fire Services
Review fee $ Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept. of Transportation _
St. Johns River Water Management District
Army Corps of Engineers --
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APP (CATION STATUS _.
Reviewing Department First Review: RApproved. nDenied.
(Circle one.) Comments:
if
, 4I 1• ` •
i,/ l • to: •
BUILDING l . /
PLANNING &ZONING Reviewed by:
N Date?/>
TREE ADMIN. Second Review: nApproved as revised. n •nied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date.
FIRE SERVICES Third Review: nApproved as revised. nDenied.
Comments:
Reviewed by:
Date.
Revised 05/14/09
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APPLICATION FOR REVIEW OF
SUBDIVISION CONCEPT PLAN
City of Atlantic Beach • 800 Seminole Road •Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800 • FAX (904)247-5805 • http://www.coab.us
Date G� 17 /L File No.
1. Applicant's Name 14' I MA t GD L LL-C- F D.vt-e!' (AL LLC
2. Applicant's Address L h, i y LAM6z.t`t'x-'
.SSS II t, '21,441,, FL 3,6z3
3. Property Location { )-4 a:wl,-e I 1<- t 1)7 D. v,ve t- Cl L- /{ Pc-16. 6 Ale--4 14
4. Property Appraiser's Real Estate Number 17(9.141 - 0000 11 1 i co 0
5. Current Zoning Classification 6. Comprehensive Plan Future Land Use designation
7. Size of Parcel E.>0 X 1110 t '70 x i uv
Application fee of $150.00, as established by Section 24-69(7)c, must be included
with this application.
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED WITH THIS APPLICATION IS
CORRECT:
Signature of owner(s)or authorized person if owner's authorization form is attached:
Printed or typed name(s): 6 h.215 �lc 7S�ti
Signature(s):
ADDRESS AND CONTACT INFORMATION OF PERSON TO RECEIVE ALL CORRESPONDENCE
REGARDING THIS APPLICATION
Name: (4i75 AK AZ/13• :" .
Mailing Address: SSS I/ 5r /,fesy Z h 4 e4-e-if
Phone: /U$ 3`/7- Z '0 3 FAX: j'v -.J`1/-97'/ E-mail: a•r-5 6,,c:��,teA
City of Atlantic Beach APPLICATION NUMBER
S ��r�y;. 10,. (To be assigned by the Building Department.)
's Y�• � Building Department `� �� , � _S FPO
-
J l
- . — `� 800 Seminole Road
---,' l Atlantic Beach, Florida 32233-544 JL/
. Phone(904)247-5826 • Fax(904 7-5845 +70 20/8 Date routed: 1
�0;11�; E-mail: building-dePt@coab.us
// ,C::7
City web-site: http://www.coab.us
APPLICATION REVIEW AN RACKING FORM
i � (0 O/�t�C-�2_._ ,M Department review required Yes No
Property Address: Building
Planning & Zoning
Applicant: C l-tR I S R An(SCI?T SZS 6 -.-) Tree Administrator
ublic Works
Project: SU ( 1V' ts t �� PLAA-0 lc ii les
Public Safety
Fire Services .
Review fee $ Dept Signature '''-v\
Review or Receipt Date
Other Agency Review or Permit Required of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants •
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
— — —— _
Reviewing Department First Review: Approved. ['Denied.
(Circle one.) Comments:
BUILDING /16 viewed b : � G/l �� Date: 7 (Y
PLANNING &ZONINGRe y
TREE ADMIN. Second Review: ['Approved as revised. ['Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
Date:
PUBLIC SAFETY
FIRE SERVICES Reviewed by.
Third Review: Approved as revised. ['Denied.Comments:
1
II Reviewed by: Date: —_
Revised 05/14/09