Water SDC Charges 550 Camelia 2011 IIy CITY OF ATLANTIC BE
� ACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number
Property Address 11-00002820 Date 10/27/11
Application type description 550 CAMELIA ST
Property Zoning p UTILITY CONNECTION
Application valuationTO BE UPDATED
----
--------
------
Application desc ---------------------
water-sdc, -meter_and_cross_connection
_-
Owner ---------------------
Contractor
DAGLEY, DONALD --------------------
550 CAMELIA STREET OWNER
ATLANTIC BEACH FL 32233
UTILITIES PERMIT
Permit -----___
Additional desc
Permit Fee CONNECT TO CITY WATER
Issue Date ' 00 Plan Check Fee .
Expiration Date . 10/27/11 Valuation • 00
-
------------------------- 10/27/11
0
Other Fees --------------------------- _____
WATER CONNECT/METER ONLY 185 . 00
WATER CROSS CONNECTION
WATER SDC-SYSTEM DEV CHG 50 . 00
---------------- ________ 1140 . 00
g
Fee summary Charged
----------------------
Paid
_ Credited
-
--------- _ _
Permit Fee Total . 00
_______ e
Plan Check Total . 00 . 00
Other Fee Total • 00 . 00 . 00
1375 . 00 ' 00 . 00
1
Grand Total 1375 . 00 . 00 . 00
375 . 00 1375 . 00 . 00
00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
�} PUBLIC UTILITIES
• 1200 Sandpiper Lane
JATLANTIC BEACH,FL 32233
(904)270-2535 or(904)247-5874
NEW WATER/SEWER TAP REQUEST
Date: - �,/ Project Address:
No.of Units:_�Commercial esident�al
ry('� Multi-Family
New Water Taps)bl f✓ ) Meter S'
New Irrigation Meter Upgrade Existing Meter from—, to___ . .__(size)
New Connection to City Sewer
Name: ��Unr.�/.,J r er
Applicant Address:
City: -_-
Phone Number: —State: gip;
Cell Number:_
Email Address Fax:
Signature:
(Applicant)
Application# QTY STAFF USE ONLY
Water System Development Charge
Sewer System Development Charge
Water Meter Only
Water Meter Tap J /"V
Sewer Tap $ A
Cross Connection $-
Other $ RGJ
TOTAL
wOA
(Tates)
APPROVED: _
Utility Dir ar or Authorized Signature)
ALL TAP REQUEST MUST BE APPROVED BY UTLMM DEPARTMENT BEFORE 16EFS
CANBEASSESSED