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,,:s `/r„ City of Atlantic Beach
o' 1Building Department APPLICATION NUMBER
as-
i.. 800 Seminole Road (To be assigned by the Building Department.)
� Atlantic Beach,Florida 32233-5445 T'�! '�—S �'Q` ` ,
Phone(904)247-5826 • Fax(904)247- 5
urs >. E-mail: building-dept@coab.us AuG Q - l Date routed: 01—I act ( 1%0
City web-site: http://www.coab.us
APPLICATION REVIE'l ' AN@-TRKING FORM
Property Address: 3.D 3 la S� 1 Q.L p_- „ent review re.uired Yes No
41111 Buil. ._.
J Applicant: Si N rlt 1. (Q �DM `�- I t ). Plannin ME
4-5 ---_ ---- g&Zoning
ree '.minis ra or
Project: ('%Q %) Si fl l
Pu. • 1_,•
4kfaMOMEM _-
Public Safety -n
Fire Services --
Review fee$ Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified B Date
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.
ly'Denied.
(Circle one.) Comments:
BUILDING --iee /' 'r t tid (• /xic 4 el-
PLANNING &ZONING
Reviewed by:,./;,2e/ Date: ";��/k
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:
sed 05/14/09