2470 MAYPORT RD - COMMERCIAL WATER & SEWER TAP CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
COMMERCIAL NEW
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-COTH-1407
Job Type: COMMERCIAL OTHER
Description: NEW WATER AND SEWER TAP
Estimated Value:
Issue Date: 6/20/2016
Expiration Date: 12/17/2016
PROPERTY ADDRESS:
Address: 2470 MAYPORT RD
RE Number: None
PERMIT INFORMATION:
FEES:
SEWER SDC-SYSTEM DEV CHG $4,050.00
WATER CONNECT/TAP & METER $370.00
WATER CROSS CONNECTION $100.00
WATER SDC-SYSTEM DEV CHG $2,280.00
Total Payments: $6,800.00
PERI1II I• IS APPROVED ONLY IN ACCORDANCE NY 1111 ALL. CII V OP VI I.A\I I( III,k( ORDINANCES :AND I III: FLORIDA
BUILDING CODES.
„,,, -COT K- 1437
i
,v , CITY OF ATLANTIC BEACH
A PUBLIC UTILITIES
15 `' 'r 1200 Sandpiper Lane
ATLANTIC BEACH,FL 32233
1=�£011]9.' (904)270-2535 or(904)247-5874
NEW WATER/SEWER TAP REQUEST
2'-/70
Date: G,- /3- Re, Project Addr : r' jf 12-T-” &410
No.of Units: Commercial Residential Multi-Family
New Water Tap(s)&Meter(s) )< Z Meter Size(s) 34/
New Irrigation Meter Upgrade Existing Meter from to (size)
New Reclaim Water Meter Size New Connection to City Sewer
Name:
Applicant Address:
City: State: Zip
Phone Number: Cell Number:
Email Address Fax:
Signature:
(Applicant)
CITY STAFF USE ONLY
Application#
Water System Development Charge $ 2 Z
Sewer System Development Charge $ r _
Water Meter Only $ 37D,06 rti r
Reclaim Meter Only $ v
Water Meter Tap $ (notes)
Sewer Tap $
Cross Connection $
Other $ • OD
TOTAL $(D,'2 00j')
APPROVED: Kayle Moore,PE
(Deputy PW Director or Authorized Signature)
ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES
CAN BE ASSESSED
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