Loading...
1632 W park Ter 2012 well CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-CO000946 Date 8/23/12 Property Address . . . . . . 163 : W PARK TER Application type description WELL: PERMIT Property Zoning . . . . . . . TO EE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc WELL ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ AYCOCK THOMAS J III & MARY ANN WILLIAMS WELL DRILLING INC 491 SATURIBA DR P. 0. BOX 330567 ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 241-8489 ---------------------------------------------------------------------------- Permit . . . . . . WELL PERMIT Additional desc . . Permit Fee . . . . 75 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/19/13 ---------------------------------------------------------------------------- Special Notes and Comments Seperate permit required for electrical connection/wiring to new pumps A reduced pressure zone backflow preventer must be installed if irrigation will be provided or if there is a private well on the property. Backflow preventer must be tested by a certified tester and a copy of the results sent to Public Utilities . ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STAT!E DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------- ------------------------------------ Fee summary Charged Paid Credited Due ----------------- ---------- ---- ------ ---------- ---------- Permit Fee Total 75 . 00 75 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 79 . 00 79 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF A rLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. City of Atlantic Beach APPLICATION NUMBER Building Department (TO be assoied by the Building Deparknent.) 800 Seminole Road Atlantic Beach,Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@wab.us Date routed: City web-site! http,/Aww.cosb.us I - APPLICATION REVIEW ANP TRACKING FORM Property Address: Department review required Yes No Building Applicant: Planning&Zoning Tree Administrator Project: Public Works Public Safety e Services 7RO low or Receipt Other Agency Review or Permit Required Of P wmit Vedfied By Date Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Affny Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other APPLICATION S TUS Reviewing Department First Revilew: V%proved. FIDenied. (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed bl,: TREE ADMIN. Second Review: ElApproved as revise:1. F]Denied. ORKS Comments: LI TILITIE 7 PUBLIC SAFETY Reviewed 6: Date: FIRE SERVICES Third Review: []Approved as revisei I. ODenied. Comments: Reviewed by Date: Revised 07127110 CITY OF ATLANTIC BEACH WELL PERMIT APPLI[CATION Date Owner's Name:/_D /0 1&e—'6�Addrest Well Address (if different than above): z— Well Location on Property (i.e. northeast corner, etc:� Well Installation Contractor: Contractor License No.: zql 7, Phone;.Z:�.7-07ej� Fax: Contractor Address: ",/ —5��e:5> .1 1 Z?�4 - � /I Check Use of Well: Domestic Irrigation 1�0/'�'Other # of Wells to be installed: # of P imps to be installed: Estimated- Well Depth:1'1'6 Casing Depth: Screen Interval fron3aftoA0 Well Diameter: Casing Material Is address currently connected to the City water syst,,m? P Is address currently connected to the City sewer sysi em?_ Has a Well Permit been obtained from the City of J ksonville? Permit# Does the well require a permit from the St. Johns River Water Management District? (Not required for wells under 2-inches diameter inst,illed by resident or wells under 6- inches diameter if installed by licensed well contrac,or). '90 If permit is required, note Permit Number at d attach a copy. I NOTE.- WHENA WELL IS INSTALLED ON YO:11R PROPERTY, YOUMUST INSTALL A REDUCED PRESSURE ZONE TYPAI BA CKFLO W PRE VENTER ON THE CITY WA TER SER VICE, ON THE CUSTO)4ER'S SIDE OF THE METER THE BA CKFL 0 W PRE VENTER MUST BE TES 1 rED B YA CER TIFIED TESTER AND A COPY OF THE RESUL IS SENT To ij;�'PUBLJC UTILITIES DEPARTMENT.