820 14th Street West Septic to Sewer 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001025 Date 12/12/12
Property Address . . . . . . 820 W 14TH ST
Application type description SYSTEM DEVELOPMENT CHARGE RESIDENTIAL (S
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
Septic to Sewer
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Owner Contractor
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SIMMONS, DEBRA A OWNER
820 W 14TH ST
ATLANTIC BEACH FL 32233
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Permit . . . . . . UTILITIES PERMIT
Additional desc . .
Permit Fee . . . . . 00 Plan Check Fee . 00
Issue Date . . . . 12/12/12 Valuation . . . . 0
Expiration Date . . 12/12/12
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Other Fees . . . . . . . . . SEWER SDC-SYSTEM DEV CHG 4050 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total . 00 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4050 . 00 4050 . 00 . 00 . 00
Grand Total 4050 . 00 4050 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
kTLANTIC BEACH, FLORIDA
.RY ASSESSMENT AGREEMENT
City of Atlantic Beach
*** CWTOKER RECEIPT *** )PERTY DESCRIPTION:
Oper: BA5HJY Type: DC Drawer: 1
Date: 12/12/12 00 Receipt no: 19125
Descri ption Quantity Amount Debra A. Simmons
2012 19UI1 5 PERMITS 820 W. 14th St.
1.00 $4850,00 Atlantic Beach, Florida 32233
RE SS: 820 W. 14th St.
Tender detail 171047.0000
CK DECK 108125 $4850.80
Total tendered 148 8.0 'TION: 18-34 38-2S-29E .281
Total payment Atlantic Beach Sec H
Trans date: 12/12/12 Time: 16:25:36 Lots 1, 2 BLK 222
tended payment agreement between you and the City of
Atlantic Beach, Florida for the above listed total amount and for which said amount will be filed
as a lien with the Court of the Circuit Court for Duval County, Florida until the entire balance is
paid.
CHARGES: System Development Charge$4,050.00
Water Meter Only 185.00
Cross Connection 50.00
Contractor 3,370.00
Filing Fees 35.50
TOTAL CHARGES FINANCED: $7.690.50
TOTAL INTEREST OVER LOAN TERM: $1,653.01
TOTAL AMOUNT OF AGREEMENT/LIEN: $9,343.51
TERMS: Number of Monthly Payments 120
Due Date Due monthly with your utility bill
Billing Included on utility bill
Late Charges 10%
Failure to pay all charges will result in the water services being cut-off.
Payment Amount $77.86 per month
Total Interest over term of loan $1,653.01
Interest Rate 4.00%
LIEN: A lien in the amount of the TOTAL AGREEMENT above shall be executed and
recorded against the above referenced properties. The owner hereby agrees to pay all
recording fees and costs involved with the execution of the lien. Upon payment being
made in full,the lien shall be released of record.
REORDER 905-U.S.PATENT NO.5538290,5575508,5641183,5785353,5984364,6030000
11
CITY OF ATLANTIC BEACH
s� 900 SEMINOLE ROAD
'.,="f.•" ATLANTIC BEACH,FLORIDA 32233-4445
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD NO. 108125
ATLANTIC BEACH,FLORIDA 32233-4445
INVOICE INVOICE PURCIIA.SE PRCIJECT ACCOUNT. AMOUNT
*MBER DATE ORDER NO.. NLI14tH R NUMBER'
RE# 171047-0000 12/05/2012 410-5506-535.34-07 4,050.00
GROSS RETAINAGE DISCOUNT NET
$******4, 050 . 00 $******4,050.00