Loading...
Permit Well 353 7th St 2012 CITY OF ATLANTIC BEACH 1 800 SEMINOLE ROAD J A " ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00001785 Date 12/26/12 Property Address . . . . . . 353 7TH ST Application type description WELL PERMIT Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc new well ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MARTINEZ JUAN CARLOS & WECHTER WILLIAMS WELL DRILLING INC MARY ELLEN P. O. BOX 330567 303 9TH STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 241-8489 ---------------------------------------------------------------------------- Permit . . . . . . WELL PERMIT Additional desc . . 1 WELL 1 PUMP FOR IRRIGATION Permit Fee . . . . 79 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 6/24/13 ---------------------------------------------------------------------------- Special Notes and Comments Seperate permit required for electrical connection/wiring to new pumps ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 79 . 00 79 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 83 . 00 83 . 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 APPLICATIONL Building Department ( � To be as 800 Seminole Road ( signed by the t) 44 Atlantic Beach, Florida 32233-5415 p ) �Z Phone(904)247-5626 - Fax(904)247 5845 %} Vilill ` E-mail: building-deptQcoab_us !1 Date routed: /2- CRY web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM 7171 S7- Property Address: MPPII Tn-g ent review re uired Yes No Applicant: ��/ Cf-yy� S �� Zoning Project: �G inistrator Project: rks litieses Review fee $ nl� Dept Signature Other Agency Review or Permit Required Review or Receipt of Permit Verified B Date Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS IReviewing Department First Review: Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed by: Date:_ TREE ADMIN, Second Review: OApproved as revised. ❑Denied. WO S Comments: PU LIC UTIL T -72,ET P ELIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ElApproved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 0712T110 CITY OF ATLANTIC BEACH WELL PERMIT APPLICATION Date Owner's Name:C &4A/ - 6AIIfZ &,yeIAddress: 3 04f j`l, Well Address (if different than above): 3 .s 3 ?f"'� Well Location on Property (i.e. northeast corner, etc.) Al- A�E Well Installation Contractor:—/—a-4,/' 41 G✓e 1114• ,sf Contractor License No.: l e7ll 7 Phone:Z3-7 aYva Fax: Contractor Address: / Check Use of Well: Domestic Irrigation !' Other # of Wells to be installed: / _ # of Pumps to be installed: Estimated- Well Depth: Casing Depth:/2- $ Screen Interval fron-l�to,,6r Well Diameter: 3 Casing Material Is address currently connected to the City water system? S Is address currently connected to the City sewer system? y s Has a Well Permit been obtained from the City of Jacksonville? -v - Permit# Does the well require a permit from the St. Johns River Water Management District? (Not required for wells under 2-inches diameter installed by resident or wells under 6- inches diameter if installed by licensed well contractor). At 4> If permit is required, note Permit Number and attach a copy. NOTE: WHENA WELL IS INSTALLED ON YOUR PROPERTY, YOUMUST INSTALL A REDUCED PRESSURE ZONE TYPE BACKFLOW PREVENTER ON THE CITY WATER SERVICE, ON THE CUSTOMER'S SIDE OF THE METER THE BACKFLOW PREVENTER MUST BE TESTED BYA CERTIFIED TESTER AND A COPY OF THE RESULTS SENT TO THE PUBLIC UTILITIES DEPARTMENT.