370 Plaza TREE18-0026 Application----------------
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, ,
TREE REMOVAL PERMIT APPLICATION
City of Atlantic Beach
Community Development Dep3rtment ({.
FOR INTERNAL OFFICE USE ONL Y
800 Seminole Road Atlantic Beach, FL 32233 1"'1-1') ___-t..:~
PERMIT # T f.ft-I ~-OD~(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.
D t;9acyTree
Q'Single-/ Two-Family Residential
D Multi-Family Residential
D Commercial/Industrial
D Institutional/Other Non-Residential
$ 25.00
$125.00
$250.00
$250.00
$250.00
SITE INFORMATION
ADDRESS o3:::fD PtAzA-~T~T RE# I b(11 b -0 c)67>
SUBDIVISION OL.P ~1l--.A+JT'c. ~~ BLOCK # I 0 LOT # ~>
APPLICANT INFORMATION
NAME r-...tp..c?J.j e. M9:t:tJAVC> J JcSepl-\ M. l~ EMAIL l jOMQ;O t;~@~A-IL.~
ADDRESS ?70 p{A~ CITY A1t.N-rnc ~&-\-STATE R---ZIP CODE ~z.Z~3
PHONE# CELL# q04---?2-r'/6<gb !BDWNER D LEGAL AUTHORIZED AGENT-
TREE REMOVAL PERMIT APPLICATION PACKAGE CHECKLIST
PLEASE ATTACH THE FOLLOWING EXHIBITS:
ftdditional 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 RE e€ IVE D
~EXHIBIT B -TREE INVENTORY and TREE PROTECTION PLAN
IY1/ EXHIBIT C -TREE MITIGATION WORKSHEET
~ EXHIBIT D -TREE MITIGATION PLAN MA Y -3 "2018
SITE PREPARATION CHECKLIST f::iU Udtng DI ~partment
Cit y of Atl ant c Beach, Fl
PLEASE PREPARE YOUR SITE AS FOLLOWS:
D Mark a\l trees identified for removal with RED or ORANGE flagging, paint or tape
D Mark all trees identified for preservation with BLUE or GREEN flagging, pain or tape
D Mark property corners with stakes or paint
D Barricade a\l 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 TREES AND NATURAL VEGETATION) AND ALL OTHER APPLICABLE CODES AND
ORD CES OF TH CITY OF ATLANTIC BEACH.
" JOse-pM M· ~
PRINT OR TYPE NAME DATE-::-;-;:T.--:'i!!¥.::'!:--:x~-==-\;i--;:-:-::=--~--------'-
DO I NEED A TREE REMOVAL PERMIT?
City of Atlantic Beach
Building and Zoning Department
800 Seminole Road Atlantic Beach, Florida 32233-5445
Phone: (904) 247-5826 Fax: (904) 247-5845 Email: Building-Dept@coab.us
Directions: Statt at Part A answering each question following the flow chalt to determine if a Tree Removal
Permit is required for your project. ~~,/"2.01"
Part A
Has there been any construction on the property in the last 2 y ars or is there any construction planned in the
next 2 years? (only consider work requiring a permit)!
Yes Did the construction have combined permit valuEl,tion of $1 0,000 or more? 'Ie
I ;
Yes Are any of the trees to be removed 6 inches or larger in diameter2?
1= ~A permit is required . PI""'", \-II~
No A permit is NOT required for your tree removal.
No A permit is NOT required under Part A. Move to Part B.
No A permit is NOT required under Patt A. Move to Part B.
Part B
Are any of the trees to be removed 20 inches or larger in diameter?
Yes Are the trees 20 inches or larger one of the followin~eCieS ?-")
Eastern Red Cedar Bald Cypress Southern Red Cedar
Florida-Ill ......Winged Elm Live Oak ,(15"ignut Hickory ./ LobloUy.Bay Pecan
"s. .~ %5fIal..L Red Maple Southern Magnolia >..J
TupeloFlorida Maple
~A permit is required.
No A permit is NOT required. Move to Part C.
No A permit is NOT required . Move to Part C.
Part C
Are any of the trees to be removed a Sand Live Oak (Quercus Geminata) that is 8 inches or larger in diameter?
~~~ A permit is required.
l@ A permit is NOT required.
1. All permitted construction on the property must be considered including plumbing,
electrical , mechanical , renovation s and addition s even if they are not related to the
tree removal.
2 . The City uses Diameter at Breast Height (DB H) for m,easurement, which is the ,
diameter of the tree trunk at 54 inches off the ground . For trees that fork below breast '
height , combine the DBHs of each trunk. For trees that fork at breast height, measure
just below the fork .
..
Ve rs io n: 5/ 16 Ba sed o n th e requireme nt s of Cha pt er 23 of the Cod e of Ordinance s
,._-..
FOR RECORDER . I·
.
TIllS INSTRUMENT PREPARED BY:
Richard T. Morehead
Richard T. Morehead, PA
920 ·C Third Street
Neptune Beach, Florida 32266
RECORD AND RETURN TO:
Mary E. McDo nald
370 Plaza Street
Atlantic Beach, F1 rida 32233
Bk: 8 362
Pg: 1651 -1652
Doc#l 96 11 5985
Filed & Recorded
06/05/96
UI 03 : 44:0Q P. M. L!~NRY W. COOK ~ILERK CIRe'un COURT
f/UVAL COUNTY ; FL ~EC . $ 10. 50
DEED $ 924 . 00
RE PARCEL ID # : 169r,6-0000
BUYER'S TIN: 26 -
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' ..... " 't.I.t • . • ~" ._.
WARRANTY DEED
'··S
THIS WARRAN1Y DEED made this 31st day of May, 19J6 by Kim D~ Leinbach, jOine~his wife, Lynn Leinbach,
hereinafter called Grantor, and whose address ~/Obll'5tii')]I,~) '. ' lm l~ Eh;'i~ .J&~to
Mary E. McDonald, a single woman, hereinafter ed rantee an whose . adaress is aza 'Street, tIantic each,
Florida 32233.
(Wherever used herein the term "grantor" and ·grantee" include all the parties to this instrument and the
heirs, legal representatives and assigns of individuals, and the successors and assigns of corporations .)
WITNESSETH:
THAT the Grantor, for and in consideration of the sum of Ten and NO /100 Dollars and other valuable
considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys
and confirms unto the Grantee, all that certain land situate, lying and being in Duval County, Florida, viz:
Lot 33, Block 10, PLAT NO.1 SUBDIVISION 'A' ATLANTiC BEACH, according to .. plat thereof as
recorded in Plat Book 5, page 69 of the current public records ofDuval County;::· Florida •
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:::·X· ~:C~;;~;
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each,~ smite--et~~Grnntie 'aD.d ~hose addiess is
(Wherever used herein the teI1Il "gran tor' and "grantee" include all the parties to this instrument and the
heirs, legal representaw.-es and assigns of individuals, and the successors and assigns of corporations.)
WITNESSETH:
THAT the Grantor, for and in consideration of the sum of Ten and NO /100 Dollars and other valuable
considerations, receipt whereof is hereby acknowle.dged, her~by grants! bargains, ~el1s,.aliens, remises, releases~ conveys
and confirms unto the Grantee, · all that certam land sltuate, lymg and bemg m Duval County, Flonda, ViZ :
Lot 33, Block 10, PLAT NO.1 SUBDMSION 'A' ATLANTiC BEACH, according to .plat thereof as
recorded in Plat Book 5, page 69 of the current public records oIDuval County;~,: · Florida.
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SUBJECT TO taxes accruing subsequent to December 31, 1995.
SUBJECT TO covenants, restrictions and easements of record, if any; however, this reference thereto shall not
operate to reimpose same. .
. TOGETHER with all the tenements, hereditaments and appurtenances thereJlllto belonging or in anywise
appertaining. .
TO HAVE AND TO HOLD the same in fee simple forever. .
AND the Grantor hereby covenants with said Grantee that the Grantor is lawfJilly seized of said land in fee simple;
that the Grantor has good right and lawful authority to sell and convey said land; fu.at the Grantor hereby fully warrants
the title to said land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free
of all encumbrances.
. IN WITNESS WHEREOF, the said Grantor has signed '!-Ild sealed these presents the day and year first above
wrItten. .
Page 1 Form SoftWare by Automated Real Estate Systems, Inc. 1-1101)..330·1295 86BI81DS
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Bo p k 8362 Pg 1652 '"
WItness Prmted SIgnature
STATE OF FLORIDA
COUNTY OF DUVAL "
The foregoing instrument was acknowledged before me this 31st day of May, 1996 by Kim D. Leinbach, joined by his wife,
Lynn Leinbach. He/She is personally known to me or has produced driver's 1 j ceuse
as identification.
(TItle or Rank)
(SenaI No., if any)Notary Pnnted SIgnature
---."---------.-----. ------:------. ..-----~~-----.--
EXHIBIT A: LETTER OF AUTHORIZATION
City of Atlantic Beach
Community Development Department
FOR INTERNAL OFFICE USE ONL Y800 Seminole Road Atlantic Beach, FL 32233
PERMIT # ______(P) 904-247-5800
OWNER INFORMATION
NAME MAn-'I 's.. /V)~A:JtVA\...JPI _
ADDRESS =5 '1--0 PLA~
Jj~fV\. I-N~ PHONE#
CELL#
Cj(J4. S-'2..S' '()S~
SAME..
CITY _/lr=--;r-,--~__--=-\L_~___-,-1_~_L-__' ___ STATE FLZIPCODE "=3Z-Z-33'
AGENT INFORMATION
NAME PHONE#
ADDRESS CELL #
CITY 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.
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT: Signature of Property Owner(s) or Authorized Agent
ER 0 LEGAL EPRESENTATIVE PRINT OR TYPE NAME DATE
SIGNATURE OF APPLICANT PRINT OR TYPE NAME DATE
Signed and sworn before me on this ___day of _______-' ____ by State of _______
County of _______
Identificationverified: ____ _________________
Oath Sworn: 0 Yes 0 No
Notary Signature
My Commission expires ___________
02 TREE REMOVAL -EXHIBIT A: Letter ofAuthorization 03,01.2018
EXHIBIT B: TREE INVENTORY and PROTECTION PLAN
City of Atlantic Beach
Community Development Department
FOR INTERNAL OFFICE USE ONLY800 Seminole Road Atlantic Beach, FL 32233
~ (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 (db h) 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 E){HIBIT 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 t ree or group of trees to be preserved.
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PREPARED BY: SCALE: 1 SQUARE =
02 TREE REMOVAL EXHIBIT B: Tree InventOfY and Protection Plan 03,01 .20 1 B /t
~' ,e EXIDBIT C: TREE MITIGATION WORKSHEET
~ City of Atlantic Beach
. Community Development Department ~800 Seminole Road Atlantic Beach, FL 32233 FOR INTERNAL OFFICE USE ONLY
(P) 904-247-5800 PERMIT#
~
List the species and diameter at breast height (dbh) of all trees identified on EXHIBIT B
10 OBH SPECIES
"X"= "[]"= "0 11 =
COMMENTS (for use by City Staff)removing preserving replacing
1 , ',S" I ~16 t..l\J[ ""C¥O(lJ.-r ~
2 I'%. " PM-M V
3 '4'" DAle::. V
4 1'2 " PA-c..M V"
5 'lIS" ~~(2€L. V
6 ~.S'7 Ct~~L. V
7 t;" '~t.~C--. V
8 I )I, . P4-L-M V
9 II " PAt..-M V
10 .s.~" C,(~~ V
11 '2,." Sl~ V
12 3" ~Myn:Tl..e V
B ('3" pALM V
14 +" C.{~~~ V
15
16
17
18
19
20
21
22
23
\
24
25
02 TREE REMOVAL EXHIBITC: Tree Mitigation Worksheet 03 .07 .2018
EXHIBITD: TREE MITIGATION PLAN
City of Atlantic Beach
Community Development Department
L 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.
,
,
PREPARED BY: SCALE: 1 SQUARE =
02 TREE REMOVAL EXHIBIT 0 : Tree Mitigation Plan 03.01.2018
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $125.00
TREE18-0026 Address: 370 PLAZA APN: 169976 0000 $125.00
Date Paid: Thursday, May 03,2018
Paid By: MCDONALD MARY E
Cashier: CB
Pay Method: CREDIT CARD 048437
Pri nted: Thursday, May 03 , 20189:21 AM 1 of 1