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955 Sailfish Drive TREE21-0025 05.20.2021 SC=="Lf,� TREE REMOVAL PERMIT APPLICATION City of Atlantic Beach ' s Community Development Department "r 800 Seminole Road Atlantic Beach, FL 32233 ;rya (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 t�^ (IC���j SUBDIVISION 2Q � �' ( U nn APPLICANT INFORMATION 1 NAME I i C ADDRESS PHONE # % �- 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 CK RE# �� 1 BLOCK # buG � _ LOT # L_c —�1rl�s ��d-�i�Qi>r-► In®�-ma�f EMAI `-' .�j j�� L ajRS �� ' CITY CffL h- CELL #Q�— tlO ggC�X OWNER STATEFL ZIP CODE ,5�� 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 El 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: 0 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 El 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 4SIGNATU S OF THE CITY OF ATLANTIC BEACH. -J �2 ire Q. Fco n I �zo F APPLICANT PRINT OR TYPE NAME DATE I 02 TREE REMOVAL PERMITAPPLICATION 03.01.2018 EXHIBIT A: LETTER OF AUTHORIZATION JCity of Atlantic Beach ,r s� Community Development Department 800 Seminole Road Atlantic Beach, FL 32233 (P) 904-247-5800 OWNER INFORMATION NAME ADDRE FOR INTERNAL OFFICE USE ONLY PERMIT # PHONE# _q SSl_J CELL CITY _ �� P)e(j( � STATE _ ZIP CODE AGENT INFORMATION NAME �� PHONE # ADDRESS CITY CELL # STATE ZIP CODE 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. 1 HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT: Signature of Property Owner(s) or Authorized Agent 0 _ HOZ SIGNATU E O OWNER PRINT OR PE NAME DATE SIGNATURE OF OWNER #2 r niiv I urs I rrt NHIVIt Signed and sworn before me on this day of �:� �� � by Identification verified: +fit ��i1 ACLiI. / �6 0 W(. Oath Sworn: 0 Yes 2 No KEAUNDRAHAWKINS Commission # GG 352294 Expires July T, 2023 Bonded Thru Troy Fain Insurance 02 TREE REMOVAL - EXHIBIT A: Letter of Authorization 03.01.2018 No#ry Signature DATE State of ( (m County of mission expires _ J �I �� ? '� c)), 3 J LI EXHIBIT B: TREE INVENTORY and PROTECTION PLAN ' City of Atlantic Beach Community Development Department 800 Seminole Road Atlantic Beach, FL 32233 FOR INTERNAL OFFICE USE ONLY (P) 904-247-5800 PERMIT # TREE INVENTORY-Please sketch an inventory in the area below or attach a site plan showing all existing trees on the property below that are 3" diameter at breast height (dbh) and greater. Please complete the following: • Note the location of all trees to be removed with an "X" • Note the location of all trees to be preserved with "l ]" • Number all trees and list on EXHIBIT C: Tree Worksheet • Show all existing and/or proposed buildings TREE PROTECTION PLAN- (If you are doing construction on the site)-Please sketch and identify in the area below or on a copy of a certified tree survey the location of the protective barricades to be installed prior to construction. Section 23-32(c) requires protective barricades to be installed around every tree or group of trees to be preserved. I PREPARED BY: SCALE: 1 SQUARE= 02 TREE REMOVAL EXHIBITB: Tree Inventory and Protection Plan 03.01.2018 EXHIBIT C: TREE MITIGATION WORKSHEET City of Atlantic Beach s-) 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 V= removing preserving 0 replacing COMMENTS (for use by City Staff) 1 2 3 4 5 6 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 02 TREE REMOVAL -EXHIBIT C.- Tree Mitigation Worksheet 03.07.2078 EXHIBIT D: TREE MITIGATION PLAN s City of Atlantic Beach i Community Development Department J Vf 800 Seminole Road Atlantic Beach, FL 32233 FOR INTERNAL OFFICE USE ONLY (P) 904-247-5800 PERMIT # Please identify the location, species and size (caliper inches) of ALL trees to be planted for mitigation credit in the area below or on a separate site plan. Please include existing and/or proposed buildings and any street names for reference points. tl el rn PREPARED BY: SCALE: 1 SQUARE= 02 TREE REMOVAL EXHIBIT D: Tree Mitigation Plan 03.01.2018 EXHIBIT B: TREE INVENTORY and PROTECTION PLAN City of Atlantic Beach Community Development Department Q 'r 7 SAWLE 800 Seminole Road Atlantic Beach, FL 32233 FOR INTERNAL OFFICE USE ONLY Tj)T (P) 904-247-5800 PERMIT # TREE INVENTORY -Please sketch an inventory in the area below or attach a site plan showing all existing trees on the property below that are 3" diameter at breast height (dbh) and greater. Please complete the following: • Note the location of all trees to be removed with an "X' * Note the location of all trees to be preserved with'[]' • Number all trees and list on EXHIBIT C: Tree Worksheet 0 Show all existing and/or proposed buildings TREE PROTECTION PLAN (Ifyouare doing construction on the site) -Please sketch and identify in the area below or on a copy of a certified tree survey the location of the protective barricades to be installed prior to construction. Section 23-32(c) requires protective barricades to be installed around every tree or group of trees to be preserved. -r1rz -1aA I V9 (K a ND, POO L. 140000 d4 low io rV1 1. PREPARED BY: SCALE, I SQUARE= 02TREEREMOVAL-EXHIBITEi. Tree Inventory and Protection Plan 03.01.2078 EXHIBIT C: TREE MITIGATION WORKSHEET City of Atlantic Beach Community Development Department A tqf LE 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 FORINTERNAL OFFICEUSEONLY PERMIT # ID DBH SPECIES X.= removing preserving replacing COMMENTS (for use by City Staff} 1 101, Palm 2 10" Palm 3 10" Palm 4 20" Sycamore 5 13" Elm 6 24" Live Oak 7 6" Holly 8 14" Pine 00 �r r .-- ov H a o a � ea i-a -. N M dt