395 12th Street TREE19-0017 ApplicationJ, TREE REMOVAL PERMIT APPLICATION
City of Atlantic Beach
Community Development Department
800 Seminole Road Atlantic Beach, FL 32233
(P) 904-247-5800
INSTRUCTIONS
1. Complete and sign this application.
2. Attach required exhibits as listed on application checklist.
3. Contact the Community Development Department if you have questions.
4. Submit the completed application and all required exhibits, along with
application fees to the Permits Desk at Atlantic Beach City Hall,
SITE INFORMATION
ADDRESS 395 12th Street
SUBDIVISION Selva Marina Unit 1 BLOCK # 1
APPLICANT INFORMATION
FOR INTERNAL OFFICE USE ONLY
PERMIT #
❑ Legacy Tree $ 25.00
Single -/Two -Family Residential $125.00
❑ Multi -Family Residential $250.00
❑ Commercial/ Industrial $250.00
❑ Institutional/ Other Non -Residential $250.00
RE# 171922-0000
LOT # S most 30140, all Lot 41
NAME Ellen G. Wheeler EMAIL egwheeler@bellsouth.net
ADDRESS 25045 Marsh Landing Parkway CITY Ponte Vedra Beach STATE FL ZIP CODE 32082
PHONE # 904-285-2068 CELL # 904-610-5798
❑ OWNER X1 LEGAL AUTHORIZED AGENT
TREE REMOVAL PERMIT APPLICATION PACKAGE CHECKLIST
PLEASE ATTACH THE FOLLOWING EXHIBITS:
*Additional information may be required, depending upon circumstances unique to individual applications
EXHIBIT A (Option 1) - PROOF OF OWNERSHIP: Copy of Warranty Deed that verifies record of owner (Clerk of Courts)
EXHIBIT A (Option 2) - LETTER OF AUTHORIZATION: Please complete if the applicant is not the owner
EXHIBIT B - TREE INVENTORY and TREE PROTECTION PLAN
EXHIBIT C - TREE MITIGATION WORKSHEET
EXHIBIT D - TREE MITIGATION PLAN
SITE PREPARATION CHECKLIST
PLEASE PREPARE YOUR SITE AS FOLLOWS:
Mark all trees identified for removal with RED or ORANGE flagging, paint or tape
❑ Mark all trees identified for preservation with BLUE or GREEN flagging, pain or tape
Mark property corners with stakes or paint
❑ Barricade all trees to be preserved on the property at the dripline
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IN THIS APPLICATION IS CORRECT. I AGREE TO COMPLY WITH ALL
PROVISIONS OF CHAPTER 23 (PROTECTION OF TREESAND NATURAL VEGETATION) AND ALL OTHER APPLICABLE CODES AND
ORDINANCES OF THE CITY OF ATLANTIC BEACH.
d:!�_�
SIGNATURE OF APPLICANT PRINT OR TYPE NAME DATE
02 TREE REMOVAL PERMITAPPLICATION 03.01.2018
EXHIBIT A: LETTER OF AUTHORIZATION
- City of Atlantic Beach
f Community Development Department
u 800 Seminole Road Atlantic Beach, FL 32233
"%o;►l�%' (P) 904-247-5800
OWNER INFORMATION
NAME Janna B. McNicholas
ADDRESS 395 12th Street
CITY Atlantic Beach STATE FL
AGENT INFORMATION
NAME Ellen G. Wheeler
ADDRESS
CITY STATE
Ellen G. Wheeler
Janna B. McNicholas
FOR INTERNAL OFFICE USE ONLY
PERMIT #
PHONE#
CELL # 912-506-1044
ZIP CODE 32233
PHONE # 904-285-2068
CELL # 904-610-5798
ZIP CODE 32082
is hereby authorized to act on behalf of
the owner(s) of those lands described
in the attached application and as described in the attached deed or other such proof of ownership as may be required
in applying to the City of Atlantic Beach, Florida, for an application related to a Tree and Vegetation Removal Permit.
HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT: Signature of Property Owner(s) or Authorized Agent
v `CSV ("C J r.`,� n� M C 1 �l i �l��l r� 3 Z2)1 Cl
I NATURE OF OWNER PRINT OR TYPE NAME DATE
SIGNATURE OF OWNER #2
PRINT OR TYPE NAME
Signed and sworn before me on this � day of WG rC ?-D/9' by
IGInin 92 McNICintolc,S
Identification verified: FG I -DL m 2.9-?. - i ZZ - -7 U — 5 q � - V
Oath Sworn: ❑ Yes ❑ No
02 TREE REMOVAL - EXHIBIT A: Letter ofAuthorization 03.01.2018
DATE
State ofL
County of 1 uyg2
N tap ry�Pture / '70/9 ��
My Commission expires C4 1 � LS✓ / (,�
/
Notary Public, State of Florida
Commission# GG 152133
My comm. expires 0cL 18, 2019
Early Piety
CERTIFIED ARBORIST
Ict PRESERVATION CONSUOR"'
ARBORIST REPORT
March 21, 2019
Janna McNicholas
395 12" Street
Atlantic Beach, FL 32266
Dear Ms. McNicholas
L01%
INTERNATIONAL SOCIETY
OFARBORCULTURE
At your request, I have inspected the 103 inch Laurel Oak on the southeast
corner of your property. This is a multi -stemmed (4 stems) tree. Laurel Oaks
live about 35-40 years and this one is at the end of its life span. I inspected
the tree with a sounding mallet and determined that each stem has heart rot
and is hollow. This weakens the stems and failure is probable. In my
opinion, this tree could be a danger to pedestrians and traffic and should be
removed.
Should you have any further questions please call us.
Early Piety, President
Specialty Tree Surgeons, Inc.
ISA Certified Arborist #SO -0584A
"Specializing In Diagnosing Tree Disease"
5960 Philips Highway • Jacksonville, Florida 32216 • (904) 733-4455
Email: troosrus@att.net a www.specialtytree.info
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rirL,;;J EXHIBIT C: TREE MITIGATION WORKSHEET
City of Atlantic Beach
Community Development Department
800 Seminole Road Atlantic Beach, FL 32233
(P) 904-247-5800
List the species and diameter at breast height (dbh) of all trees identified on EXHIBIT B
FOR INTERNAL OFFICE USE ONLY
PERMIT #
ID
DBH
SPECIES
"X"=
removing
"[ ]"=
preserving
„o„=
replacing
COMMENTS (for use by City Staff)
1
10"
Palm
•
2
10"
Palm
•
3
10"
Palm
•
4
10"
Palm
•
5
103"
Multi -trunk Laurel Oak
•
6
12"
Palm
•
7
12"
Palm
•
8
24"
Holly
•
9
14"
Laurel Oak
•
10
12"
Palm
•
11
14"
Palm
•
12
4"
Oak
•
13
10"
Palm
•
14
10"
Palm
•
15
2"
Magnolia
•
16
r0<<;
``
G'1
17
18
19
20
21
22
23
24
25
02 TREE REMOVAL -EXHIBIT C. Tree Mitigation Worksheet 03.01.2018
Date Paid: Tuesday, March 26, 2019
Paid By: AF AB VENTURE LLC
Cashier: CB
Pay Method: CHECK 1003
/
Printed: Tuesday, March 26, 2019 1:49 PM 1 of 1 1'