Permit 432 Irex Road T CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247 -5826
Application Number 05- 00029530 Date 1/12/05
Property Address 432 IREX RD
Tenant nbr, name REPLACE 12 FIXTURES
Application description . . PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Owner Contractor
LOGAN STYLES SMITH PLUMBING, INC
432 IREX ROAD 1537 PENMAN ROAD
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 241 -4131
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 119.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Fee summary Charged Paid Credited Due
Permit Fee Total 119.00 119.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 119.00 119.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING
CODES.
BUILDING OFFICIAL
i.a41. , CITY OF ATLANTIC BEACH
d ` t f r - , PLUMBING PERMIT APPLICATION
VtI33
Date:
Property Address: ,
ddress: L A 2 t`� f� kel
Owner: (� .,� Telephone #: �.. ( -(� ` 9 /
c 11 --,-__ , p, .
Contractor: t )•-t . . -- ' - -- `� Telephone #: ,,4 (— 3 i
Contractor Address: 1 5 3 _ 1 0.17 y ti� :,� F #: 2 2 " 3O1
In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said work in
accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach
ordinance and standards of good practice listed therein.
Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing
Code.
Plumbing Type: If other construction is being done on this building or site,
. ❑ New list the building permit number:
`''Re -Pipe
Number of Fixtures:
Bath Tubs Showers
2 ' Closets Shower Pans
Dishwashers I Sinks
Disposals Urinals
Floor Drains [ Washing Machine
Lavatory C Water
Sewer ( Water Heaters
Other
Fees
Permit Issuing Fee: $35.00
Total Fixtures: )2 X $7.00 + $35.00 =
800 Seminole Road • Atlantic Beach, Florida 32233 -5445
Phone: (904) 247 -5800 • Fax: (904) 247 -5845. http : //www.ci.atlantic- beach.fl.us
*3zo
CITY OF
,1eGtucelc tSeae. - 76n art
800 SEMINOLE ROAD
'- — — ATLANTIC BEACH, FLORD7A 32233 -5445
TELEPHONE (UM) 247-5800
FAX (%4) 247 *l)S
August 17, 1995
Janna J. Thomas
432 Irex Road
Atlantic Beach, FL 32233
Dear Mr. Thomas:
Our records indicate that you are the owner of the following
property in the City of Atlantic Beach, Florida:
432 Irex Road
a /k /a Lot 5, Block 11, Royal Palms 2A
RE *171422 -0000
An investigation of this property discloses that I have found
and determined that a public nuisance exists thereon as to
: constitute a violation of Section 12 -1 -3 of the Code of Atlantic
Beach (high weeds and grass), i.e., front and rear yard and both
sides of fence.
You are hereby notified that unless the condition above
described is remedied within fifteen (15) days from the date
hereof, the City will remedy this condition at a cost of the work
plus a charge equal to 100% of the cost of the work to cover City
administrative expenses, which will be assessed the property owner
or occupant. If not paid within thirty (30) days after receipt of
billing, the invoice amount plus advertising costs, will be posted
s a lien on the property.
Within fifteen (15) days from the date hereof, you may make
written request to the City Commission of the City of Atlantic
Beach for a hearing before that body, for the purpose of showing
that the above listed condition does not constitute a public
nuisance.
Sincerely,
Karl W. Grunewald
Code Enforcement Officer
KWG /pah
cc: City Manager
VIA CERTIFIED MAIL
RETURN RECEIPT REQUESTED
CITY OF ATLANTIC BEACH
ROOFING PERMIT APPLICATION
JOB LOCATION: h'3c
OWNER OF PROPERTY: (; ZZeG4 C cao f'f��4
CONTRACTOR C (I ,&)S 4L' S31 JZ -t 5 /pdj =riC=
CONTRACTOR'S ADDRESS: f?`?! k t(SG- / fl L /
STATE LICENSE NUMBER : /e C'OO O? /y' TELEPHONE: ?y- c71:8-r
DESCRIBE WORK TO BE PERFORMED: /'2(e fCvdl
VALUATION OF PROPOSED CONSTRUCTION / DGY) "-
MATERIALS TO BE USED: Z.4 'C' R/T P,' ° I
SIGNATURE OF OWNER:
SIGNATURE OF CONTRACTOR: I 2
Liability Insurance Supplied
Workers Compensation Insurance Supplied
License Information Supplied
i
DEPARTMENT OF BUILDING PERMIT NO. o
CITY OF ATLANTIC BEACH, FLORIDA
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB rint 9 I A 7 21
r i
Date July 21 19 ___$Z i 2e i 1 A 7/21 / E3 '
itl0"l
Valuation $
1. 127.00 Fee$ 1
This permit not valid until above fee has been paid to City Treasurer, and is
subject to revocation for violation of applicable provisions of law.
This is to certify that Essie M. Starks
has permission to 4
enclose ca *ort a ae • -
RS•
Classification
Res ] deIlt ial Zone
Owned by Essie M. Starks
' I Lot
5 Block_____11. -- -5/D o val Palm
House No. 432 Irex Road
According to approved plans which are part of this permit
NOTICE —ALL CONCRETE FORMS
t AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
0' �---- ' O Building material, rubbish and debris
�� Ft from this work must not be placed
in • u • lic space, and must be cleared
an. hauled away by either con -
,tra . o or owne
uilding Official
111M I DATE CONTRACTOR
FOR OFFICE
USE ONLY
miTtamili
PLUMBING
ELECTRICAL 11111111111111111111
SEWER
WATER
iiiik
Alk
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t 1 i --, //2
Address LI J(: k' J / r 2. '
Heated Square Footage @ $ per sq ft = $
Garage /Shed @ $ per sq ft = $
Carport /Porch f LID @ $ ,,c per sq ft = $ 4 y,;"7, 6 e
Deck @$ per sgft =$
Patio @ $ per sq ft = $
TOTAL VALUATION: $ / / / L '),,
Total Valuation a 2 Q0 is ;� , c � cab $ S� (� .
1. ,c`.00 $ S. 0 a
Remainder Valuation $ . per thousand or
portion thereof
Total Building Fee $ /0. 0 6
ADDITIONAL PERMITS and /or FEES REQUIRED d
+ 2 Filing Fee $ S .
Mechanical Fireplaces @ 15.00 $ `—
Plumbing BUILDING ' PEMIT FEE $ / S: - o
Electric /New
Electric /Temp
Septic Tank BUILDING PERMIT $ / 5. V d
Well WATER METER CHARGE $
Switnning Pool SEWER IMPACT FEE $
Sign WATER IMPACT FEE $
Water Connection MISCELLANEOUS $
Sewer Connection $
Water Meter $
Elevation Certificate
GRAND TOTAL DUE
CALCULATIONS and /or NOTES
U
CITY OF AILANTIC BEACH L 1 198/
APPLICATION ID MAKE ADDITIONS OR ALTIERATIMS..
ll
ivAnci and Zonin
Owner a.t.... inikSf/---aa. Address 4 --TrZ x 74 Phone V Y.- 66. y
Ardiitect Address Phone
Ccyntractot i Px.Y...e/Y...Z.
i, Address '
'. Phonelii- retj ct
Contractors License/Certification Nuibers
Expiration Date
_....„..., , ,.....,„
Property Address 1,/,...1 ._.,/-- re
A
-' A1 , 1
. a 4 1 i A4A -/4 Zoning
Lot # .5 1(t c( Unit #, J/ Subdivision
Valuation of Construction $ ilr-r Type of Construction
Describe Work to be Performed
Materials to be Used ife2r:4,, 1.4-d;
i 4
Present Use of Building -4
Proposed Use of Building '3
Flood Zone ik.)
Dimensions of New Area:
•
HEATED
GARAGE OR STORAGE
.--- R)OR PORCH
•.
DECK
PATIO
YES NO NUMBER
- - -
Will there be an increase in nunber of units?
____--
Will there be a decrease in nunber of units?
___ ____
Ae%
Any additional plumbing fixtures?
____
Any new fireplaces? ....._ _
SUBMIT TWO OOMPLEIE SETS OF PLANS INCLUDING SITE PLAN
Signature OWNER m /27 / ,51444--vp Date 7—
Signature CONTRACTOR (Pf2eW 4.4.:4.3. Date 7^/5-...--7
n.
:o SENDER:
a • Complete items 1 and /or 2 for additional services. I also wish to receive the
a • Complete items 3, and 4a & b.
• Pr your name and address on the reverse of this form so that we can following services (for an extra cii
>
0
r this card to you. fee): a
0 • Attach this form to the front of the mailpiece, or on the back if space 1. m Addressees Address ' m
does not permit. N
.0 • Write "Return Receipt Requested" on the
rriel�fiece below the article number. G
2. ❑ Restricted Delivery
• ere and the date
'' • The Return Receipt will show to whom the article was delivered
C delivered. 76
0
Consult postmaster for fee.
lb
3.. Article Addressed to: 4a. y Article ` Number /
tc
E 'y Zii'SC Q 4b. Service Type m cc
❑ Registered ❑ Insured
y 1 G3 G 32233
l y Certified ❑COD e
oC
ID Express Mail ❑ Return Receipt for c
0 M rch
7. Date of Deli
F Cr , -F Y I /' 8. Addressee's A dre s (Only if requested .
�-� and fee is paid) c
a 6. Sigt,re Agent) m
0
> PS Form 3811, December 1991 *U.S. GPO: 1993-352-714 DOMESTIC RETURN RECEIPT
CITY OF ATLANTIC BEACH, FLORIDA
4 5 Y ( 5
Approvwdby APPLICATION FOR ELECTRICAL PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE: ti / 19
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE
HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS,
WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF
ATLANTIC BEACH ORDINANCES.
/ E/� i S'rvr;pt C ( -
ELECTRICAL FIRM: MASTER ELECTRICIAN SIGNATUR JOURNJYMA(y
NAME l ''5 .W 5 ADDRESS: e/ 7 2 X' x RFD BOX
BLDG. SIZE BETWEEN:
it5 g »L t`) —J ' / i`a✓•
RES. p APT. ( ) COMM. ( 1 PUBLIC ( ) INDUS. ( ) NEW ( ) OLD 1 1 REW. ( 1
ADDITION ( 1 TRAILER 1 1 TEMP. 1 1 SIGNS ( 1 SQ. FT.
SERVICE: NEW ( ) INCREASE 1 ) REPAIR 1 ) FEE \
CONDUCTOR SIZE AMPS COPPER ( ) ALUM.1 f
SWITCH OR BREAKER AMPS PH W VOLT RACEWAY
EXIST. SERV. SIZE /'' AMPS l PH WLT RACEWAY
FEEDERS NO. SIZE NO. SIZE NO. SIZE
LIGHTING OUTLETS CONCEALED OPEN TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
0.30 AMPS. 31-100 AMPS.
SWITCHES
INCANDESCENT
FLUORESCENT & M. V.
FIXED 0.100 AMPS, I OVER
APPLIANCES I BELL TRANSF.
AIR H.P. RATING H.P. RATING
CONDITIONING COMP. MOTOR OTHER MOTORS AMPS CEIL HEAT: KW -HEAT s'
MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS
MISCELLANEOUS
1 11 I1
5-
DEPARTMENT OF BUILDING
FOR OFFICE USE ONLY
CITY OF ATLANTIC BEACH, FLORIDA Date? -:= / ,
Permit #/J Fee S_3 o-.
r Application for Permit for Valuation , ..�
Miscellaneous Alter HOUSE # Q `""`
' r
and Repairs "
(State if to repair, alter, add to or move building, e c "..:; ( .
signs, etc.) erect �n}s,
Building on: Zot No. Bik No. / / sub , \
s 1. t i �r ___ ., Valuation 2 S . ' m . ---
Owner'e N *e uation S 'o :.tea
BUILDINGS AND OCCUPANC . -
Bu. ding Use - Residential or Business
What Plumbing work to be done? ---
Size of Present Bldg• Size of Extension r
No. of stories now after altered Material of roof m ot size
Material of Presen B ildin ---+
g Material o Exte1 ,
NECESSARY PLANS TO BE SUBMITT?.�D HEP?EW :T'
OIL BURNER OR GASOLINE EQUIP2ENT
Name of Oil Burner or Gasoline Pump Type or e'del
Name - and Address of Manufacturer'
Ia cenlaection herewith, application is also made to ilal T: --- ,� t--
gal. capacity tank (s) ntade by of r
_.. ground. g'a�tg m�:tal
U or Above (Name of Manufacturer) U a;wi o ov ► -
(Inside or outside) of building. For
dame of c:f"73 17 -_..-._�__._--
_„,- FURNISH DRAWING SHOWING ENTIRE LAYOUT ON REVERSE SIDE Off'
THIS BLANK
SIGNS
Size Classification
(State whether ground, roof, wall, L a ing,banner)
Material of Construction
Illuminated? Type of illumination
Will sign be over public property? State whet~Ii' >,mL, a i eonj`
SUBMIT DRAWING SHOWING CONSTRUCTION OF SIGN AND ' OD 0 E ,r - N
WRITE ADDITIONAL INFORMATION BE CW
- -- (For canvas awnings provide dimensioned a
p=' parr = Rye o i:3e )
IMPORTANT NOTICE:
In consideration of permit given for doing the work as described
in the above statement, we hereby. agree to perform sz.1i.d work in
accordance with the attached plans and specificationa, which axe a
part hereof, and in accordance with the building "` regulations of the
City of Atlantic Beach. (Southern Standard Building CO jle) .
Signature of Build , or Owner
Ad i Stilt .�
L - . a t Phone No. e
FOR OFFICE USE ONLY
a Date Feb. 26 19 70
..' Permit # 905 Fee $ 30.00
CITY OF ATLANTIC BEACH Valuation $ 10, 000.00
FLORIDA House # 432 Irex Road
,
APPLICATION FOR BUILDING PERMIT 3-3,2y_ 3
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the
building or other structure described. This application is made in compliance and conformity with the Building Ordinance of
the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic
Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether
herein specified or not.
The Contractor or Owner - Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub-
contractors engaged by him are duly licensed in the City of Atlantic Beach, Florida. To prevent delay or embarrasment regard-
ing intermediate or final inspections it is suggested that a list of sub- contractors be submitted to this office so that licenses can
be verified.
2 -19 -70
R. L. Johnson Constr. Co. 649 R - ia - day, Ja 1 .
Owner R3 _. AddressIMISMcgntZe Telephone No.3-1.5-7-
Architect R . L . Joh -- G . C - o . Address Telephone No.
Contractor Builder RX4jIXISWAIX � �
Address 4 Telephone No.39
Lot No. 5 Block No 11 Sub Division Ro sal_._Pa.lms Zone
Irex Rd . Street west Side Between Triton Rd and Eabalo Drive Sts
Valuation $ 10 ,000 For what purpose will building be used res Type of constructionBric Veneer
Dimensions of Building 246/k/A76 Dimensions of Lot 80 X 93 Size of Footings 8 X 20
Size of Piers Size of Sills Greatest Sill Span in ft. Type RoofAa.f1-p.__
How will Building be Heated? Centre 1 Gas Will Building be on Solid or Filled Ground? Solid
Size of Ceiling JoistsTrus s e S , Distance on Centers , Greatest Span "
Size of Floor Joists Slab , Distance on Centers , Greatest Span "
Size of Rafters 2 x 4 Trusses , Distance on Centers 24 , Greatest Span "
F _ IIr in E I ' This rectangle is to represent the lot.
l (- i Locate the building or buildings in the
right position. Give distance in feet from
all lot -lines and existing buildings.
C B 2 0 i 9 7 v REAR LOT LINE
Two copies of plans and specifications shall
be submitted with application. THE CITY OF ATLANTIC BEACH
Inspections required.
1. When steel is in place and ready to pour footing.
2. When steel is in place and ready to pour columns and /or lintel. 11--1 ZZ
.
3. When steel is in place and ready to pour beam. ►a
4. When framing is completed. p 0
5. When rough plumbing is completed, and ready to cover up. '-7 .]
Cal PI
6. When septic tank drain field or sewer is laid but before it is covered.
7. Electrical inspection by City of Jacksonville. I FA r
8. Final inspection.
Note: In case of any rejection, re- inspection MUST be called for after
corrections are made.
FRONT OF LOT
In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said
work in accordance with t e attached plans and specifications, which are a part hereof, and in accordance with the building
regulations of the City o lan
/ t' e .
Signature of : - Signature of -�: 5 P° __ __ . e °c ..
DEPARTMENT OP BUILDING
CITY OF ATLANTIC BEACH, FLORIDA
PERMIT TO BUILD PERMIT No
THIS PERMIT MUST BE POSTED ON JOB
Date__.__ reb' 2i
valuation s • OSO.00 F ees j0. 00
Tae parftit set ollid midi above fee has been paid y to p City Treasurer, and is
N ve ttar
subject taoadoe (. LI.o ovLr.C�llnS O ror4i94s L . of
This is to certify that CC =�x Qn C _ •. _
akookoonril3ot Ida.
has permission to build !. . 263twoul per plena
and application.
Classification
---__ ---- -_Zon
Owned by x � _ INOW �4j s R. L. Jo nson Cons r,
Lot_ f
Block BL
1
House Nom_ , =tom Mood Atlantic . Fla. lboafilt
According to approved plans which are part of this permit
NOTICE --ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN.
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
'e AFTER DATE OF ISSUE
4-----#
0
4 1. O Building material, rubbish and debris
z from this work must not be placed is
Public space, and must be cleared up
and hauled away by either contractor
or owner.
�_ auitdiai *ow.
POR OFFICE PERMIT �. _ .
•
UBE ONLY NUMBER DATE CONTRACTOR
PLUMBING
ELECTRICAL
DEWIER �/"—
WATER
I
DEPARTMENT OF gU1LDING
F CITY OF ATLANTIC BEACH, FLORIDA
,.
rHisP ERMIT TO BUILD t� L.
MUST PE TI ? No. • _ ; 1CK
BEPOSTEp J 006 - C1
JOB s
Date 0 • t� CiC4 rt+:
Valua $ I, 60g. 25 � t o b er 9 i
in 10 /C9 /t
I
_
19 84
This Fee $ I5 . DO t C10 j
I Permit not valid until above fee has
subject to revocation for violatio of a been c ab l to o v i
This i PPlicabl r Y Treasurer and is
to certify that provisions of law.
M RS • ESSIE WIL
has 432 irex Roads Atlantic ,HER
permission to build ant Beach Addition to
8 t1Ii Utility R
Classification Plans Submitted
as p
Submi
Owned by � � ,
Lot
Mrs. E ls ie Witche
I Hou se N
Block
I Accordin to approved Z. ' 0 " I �- 'S/D
plans which are part of this p erm i t
NO TICE—ALL
AND CONCRETE
SPECTER BEFORE POURING.
IN-
EBE FORMS
PERMIT DU RING.
011---_____+ AFTER VOID SIX MO NTHS
z Buildin
ter TE OF ISSUE from 1 n public work material, and debris
a space, and be Placed
,_ t acandQ kr ner wa m y e b o
Y b n. -
FOR OFFICE
' ri:: .''"1 Cam.- ti. '' `� -
USE ONLY P ERMIT
NUMBER
PATE Building Official,
PL UMBING
.._...
CON TRACTOR
1 ELECTRICAL
S EWER
WATER aliall
>
p,pFCJ1/�.p � i f
r I ^N i iC BEACH Date `
DEPARTMENT OF BUILDING
,�c1 City of Atlantic Beach, Florida
• / ' A•' .1 ",; �, 'eit�(it for Permit No.B E Office
IyM b. ,,4 -4 • s Alterations ' Use
and Repairs M P Only
Contractor "
Lf_, t `� :,/ ` 32 rf' f( Phone --, /
Owner 7i, 2;, C.:,L?t.t / , % ,J,2. ,/'' Phone
The undersigned hereby applies for a peLmit to
. c . ,, / til g* ,./.7;-,/,,
‘,4,,,
Building on ,v/// ,_,,es m part of Lot No. Block Subd . ,�
At side of t, y 6 ,
between ( A 2 % 1 . Ai 1, 514 :a 4 . ; �, �a'� s,,4/ 1
c �� �' Streets.
Valuation $ ,,, ,5 L;, v Present use for building v<
If residential, what type dwelling (single - family, duplex..)
How many families accomodated now? , When altered?
If business, what type? _-_.__...._.._
Will food be prepared for sale on premises?
What plumbing /mechanical work to be done?
Size of present building 3'7 '7 "r/ 2/7 ' Size of extension /'7"/i5
Size of lot 70 / " 9,f
Number of stories now L2,_ When pltered C ?/ {a _ .
— 'g 4 ,
building i$ /� ,� `� � 4 Material of existin
✓ r
existing g � ,� E xten� ion /47/4Q./7e. ... 5r;
NECESSARY PLANS IN DUPLICATE TO BE SUBMITTED HEREWITH
In consideration of permit given for doing the work described in the
above statement, we hereby agree to perfotn( said work in accordance
with the attached plans and specifications, which are a part hereof, and
in accordance with the building regulations of the City of Atlantic Beach.
7,2.4 _ d3, 4, /, t 2 Signature Contractor Date
Si
g �f
�� (_4i lip', ,j p4 /�� / /
— �/�1 y
Signature Owner Date ///
ADDRESS MECHANICAL PERMIT) /__
- — PLUMBING PERMIT #
BUILDING PERMIT WORKSHEET ELECTRIC PERMIT #
TEMPORARY ELECT. #
Heated Square Footage @ $ per sq ft = $
Garage /Shed @ $/1) .' per sq ft = $ /, e 2.,' ' ' ;
_
Carport /s7 @ $ per sq ft = $
Porches @ $ per sq ft = $
Deck @ $ per sq ft = $
Patio @ $ per sq ft = $
TOTAL VALUATION $
r
L- s/-) i.e/
Total Valuation Data 1st $ / , , <" ' 1 ,
c;. '' 4;, $ .'
Remainder Valuation @ $ c ') . -)='' per thousand
or portion thereof
TOTAL BUILDING FEE $ 'li
+ 2 FILING FEE $
FIREPLACE @15.00 $
TOTAL BUILDING PERMIT $ Z. ``'
PLUMBING PERMIT FEE$ MECHANICAL PERMIT FEE$
ELECT. TEMPORARY $ ELECTRICAL PERMIT $
WATER METER SIZE $ ACCOUNT NUMBER
SEWER IMPACT FEE $
WATER CONNECTION $ ( @10.00 per fixture unit)
i. ,- e' Ca
APPROVED BY: TOTAL BUILDING /PLAN FILING FEE $ /,,,;.),
' � ' P t? 0 �/ F'
t , r f j� r - Pi T OTAL WATER METER CHARGE $
TOTAL SEWER IMPACT FEES
Cr , TOTAL WATER CONNECTION CHARGE $, ' '
e pow �� r
MISCELLANEOUS CHARGES $
. —
vr
GRAND TOTAL DUE: $ )5- •
> -
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APPROVED
-; -- iTiANTiC BEACH
L.:.. .
, !•_ - ,317--C; OFFICE: t
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