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0 Camelia Street TREE20-0020 05.26.2020 SCTREE REMOVAL PERMIT APPLICATION �J 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 0- R�t A,. SUBDIVISION APPLICANT INFORMATION NAME /�Q,J/ FOR INTERNAL OFFICE USE ONLY FILE # ❑ 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 &� / 71 1-7 (?C o o RE# BLOCK # LOT # 4i)�—/ ADDRESS D EMAIL , C STATE,� ZIP CODE PHONE# ���-CELL# *C171 d OWNER ❑ 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 [�G EXHIBIT A (Option 1) - PROOF OF OWNERSHIP: Copy of Warranty Deed that verifies record of owner (Clerk of Courts) �(r��} ❑ EXHIBIT A (Option 2) - LETTER OF AUTHORIZATION: Please complete if the applicant is not the owner EXHIBIT B - TREE INVENTORY and TREE PROTECTION PLAN ❑ EXHIBITC -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. J / Ui �2 c� �Qr X57 SI ATUR�OF DLPRINT OR TVP AME DATE 02 TREE REMOVAL PERMITAPPLICATIONO3.01.2078 '�7-- 2�` c- oa:Q/ AM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $18.50 DEED DOC ST $280.00 PREPARED BY, RECORD AND RETURN TO: Christopher J. Hurst, Esquire Christopher 1. Durst, P.A. 4540 Southside Boulevard, Suite 302 Jacksonville, Florida 32216 File #: H04-308 Parcel Identification Number: 171017-9000-S WARRANTY DEEB THIS WARRANTY DEED made this Sth day of December, 2044, by Stella H. Tsai, a married woman, hereinafter called Grantor, whose post office address is 1906 Woodleigh Drive West, Jacksonville, Florida 32211, to David R. Shields and Janet C. Shields, husband and wife, hereinafter called Grantee, and whose post office address is 53 Oceanside Drive, Atlantic Beach, FL 32233. (Wherever used herein the term "grantor" and "grantee, {/G�_ representatives and assigns of individuals and the successors andlude assgnsl of corporations).the Parties his instrument and the heirs, legal V f 0 WITNESSETH: THAT the Grantor, for and in consideration of the sum of Ten other valuable considerations, in hand paid by the said Grantee, and No/100 Dollars ($10.00)ishe and • acknowledged, hereby the receipt whereof is hereby g y grants, bargains, sells, aliens, remises, releases, conveys and confirms to the said Grantee the following described land situate, lying and being in the County of Duval, State of Florida, to -wit; Lot 1, Block 201, Section "H" Atlantic Beach, according to plat thereof as recorded in Plat Book 18, page 34, of the current public records of Duval County, Florida. Said property is not the homestead of the Grantor(s) under the laws and constitution of the state of Florida in that neither Crrantor(s) nor any member of the household of Grantor(s) reside thereon. Grantee's Federal ID #: SUBJECT TO saxes accruing subsequent to December 31, 2004. SUBJECT TO ,covenants, restrictions and easements of record, if any; however, shall not operate to reimpose same. this reference TOGETHER with all the tenements, hereditaments and appurtenances thereunto belonging or in anywise appertaining. W"T"ty Dae& (individual) with aaa-haawtead Page I of 2 TO HAVE AND TO HOLD the same in fee simple forever. AND the Grantor hereby covenants with said Grantee that the Grantor is a of said land in fee simple; that the Grantor has good right and lawful authority to sell and l the Grantor hereby frilly warrants the title to saiconwfulul ly seized land and will defend the same against the said land; lawful clathat Of all persons whomsoever; and that said land is free of all encumbrances. ms IN WITNESS WHEREOF, the said Grantor has set their hand and seal the day and year first above written. Signed, sealed and delivered in our presence: St�JaH.�Tssj Witness #I printed name fitness #2 signature . Witness #2 printed name STATE OF FLORIDA COUNTY OF DUVAL The foregoing instrument was acknowledged before me this 8th day of Dg r 2004, by Stella H. Tsai, who is/are personally known to me, has/have produced va2'd d ' has/liave produced Werremy Deed (t"VWwl) with noa-h0-M11a4 Page 2 of 2 i river s licenses or _ as identification.- ) Notary public My Commission Expires: (Notary Seal) Kfl** L Pullet MYCOMMkq"# gM4M6 QM ":2006 60HDea'=Fap4NIN511 W- U.S. 0 0 r N OU SBZ`22' 00" E 50. r0.5' -% � E 0 ° 0 N N Z 00 2 `SCOO) ODomU Z Jm � Z cnzw \Iice � m O� IR mi LL. 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