125 Donner Road TRP 2016TREE & VEGETATION REMOVAL PERMIT APPLICATION
INSTRUCTIONS (1) Complete and sign this form. (2) Attach the required supporting exhibits as listed on the application checklist. (3) Contact the Department of Community Development if VOlt have questions or need assistance completing the application or determining which exhibits are required for your partk.'ularpi'Oject. (4) SUbmit this form, along with all required exhibits and payment to the City of Atlantic Beach, and in the appropriate amoUnt according to the application fees listed to the right, to the reception desk at the Building Department.
SECTION 1-SITE INFORMATION
PHYSICAL ADDRESS tJ.5 J)o.v,v<ll.. t<oAO
City of Atlantic Beach Department of Community Development 800 Seminole Road Atlantic Beach, FL 32233 (P) 904 247-5800 (F) 904 247-5845 j Single-/ Two-Family Residential $125.00 ~Matti-FamI1y Residential 1o..vphf>Me $250.00 j : Commercial/industrial $250.00 I : institutional/Other Non-residential $250.00 Application # TREE I(P -DR,'!-I Is
Ifan address has not been assigned to this property, contact the AB BUilding Department at (904) 247-5826 to request an address.
SUBDIVISION BLOCK LOT RE #
SECTION" -APPLICANT INFORMATION rv6'"WNER I LEGAL AUTHORIZED AGENT *
NAME OF APPLICANT la.S Vo,v,v<jL Gr>l LL-G
ADDRESS OF APPLICANT 3 S-S:" 1\ ~ 6tre.et-, Atf.\...vbc... fu-tc£ , fL 3;ld. 33
PHONE ______ CELL cro~I -3£.' ct -Z~{J3 EMAIL C.hr.5d) e-l ;+Gho.wJ<=.(.~
SECTION /11-TREE & VEGETATION REMOVAL REQUEST
I REQUEST THAT THE TREES & VEGETATION ON THE ABOVE DESCRIBED PROPERTY AND INDICATED ON THE ATIACHED REQUIRED
EXHIBITS BE APPROVED FOR REMOVAL, AS PROVIDED IN THE CITY OF ATLANTIC BEACH VEGETATION CODE, CHAPTER 23, FOR THE
FOLLOWING REASONS (check all that apply):
I Vegetation (trees) are difficult to maintain / owner dislikes.
j Trees are dead, diseased or so weakened by age, storm, fire, or other injury so as to pose a danger to persons, property,
improvements or other trees.
I Vegetation (trees) pose a safety hazard to pedestrian or vehicular traffic or cause disruption to public utility services.
j Vegetation (trees) pose a safety hazard to buildings or structures.
I Vegetation (trees) completely prevent access or cross access to a lot or parcel .
. yegetation and/or trees prevent development orphysical use. It is the intent ofthis provision that a permit shall be granted for rvthe removal ofvegetation and/or trees when the applicant has demonstrated an effort to design or locate the proposed
improvements so as to minimize the removal ofvegetation and/or trees.
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED WITHIN THIS APPLICATION IS CORRECT AND I AGREE TO COMPLY
WITH ALL PROVISIONS OF CHAPTER 23, PROTECTION OF TREES AND NATURAL VEGETATION, AND ALL OTHER APPLICABLE
COD?':'7CC'TY Of ATLANTIC BEACH. _ 6'_---,-_A_--=_ A~Y';6,--_______
SI~F APPLICANT DATE
FOR IrvrERNAL OFFICE USE ONLY
FRONTAGE FLU ZVAR ESA SRI
DEPTH ZONING UBEX HIH SR-l
AREA ISA WAIV DAB CR
T,.ee & Veg etation Removal Pe,.mit Application_versionol.ol.o9
EXHIBIT C. TREE VEGETATION MITIGATION WORKSHEET Application # TREE _-____ ~~-1 t . _l 0 ,0\ )( 2 Hit Lv rJ OA)L. X 1 Fl it P~' fY\ X I 4 ') 6 I 7 , 8 9 10
11 I
12
13
14
1,)
16
17
18
19
20
21
22 I
21
24 I
2') ,
26
27
28 I
29 ,
10 ,
11
12
13
34 I
35
36
17
18
19
40
41
42
43 I
44 I
4')46
47
48 I
49
50
""''''1Snlllf..'~''' "'I' 1T.TIi' 1[.[flU J II ''':-''J' ',,'.
1 of 2 EXI-118fT C_Tree & Vegeto/;on MitigaLion WorksheeCvers;onoJ.oJ.09