PPRI23-0001 Utilities FeesWater System Development Charge $
Sewer System Development Charge $
Water Meter Only $
Reclaim Meter Only $
Water Meter Tap $
Sewer Tap $
Cross Connection $
Other $
TOTAL $
City of Atlantic Beach
PUBLIC UTILITIES DEPARTMENT
902 Assisi Lane
Jacksonville, FL 32233
(904) 247-5886
NEW WATER / SEWER TAP REQUEST
Date Service Address
Number of Units Commercial Residential Multi-Family
New Water Tap(s) & Meter(s) Meter Size(s)
New Irrigation Meter Upgrade Existing Meter from to (size)
New Reclaim Water Meter Size New Connection to City Sewer
Applicant Name
Billing Address
City State Zip
Phone
Email
Applicant Signature
Application #
CITY STAFF USE ONLY
All fees must be paid before meter
set/establishing service.
(Notes)
APPROVED Date
Public Utilities Director or Authorized Signature
**THIS IS AN APPLICATION ONLY. ONCE FEES ARE ESTABLISHED, PLEASE NOTIFY THE UTILITIES DEPARTMENT IF YOU
WOULD LIKE TO PROCEED WITH THE PERMITTING PROCESS AND A PERMIT NUMBER WILL BE ASSIGNED TO THIS
APPLICATION.
3/9/2023 30 Dutton Island Road
1 x
x 3/4"
PPRI23-0001
8,140.00
Chris Walker 3/9/2023
1,140.00
4,050.00
800.00
2,100.0050.00