Untitled NOTICE OF INTENT TO CH GENERAL PERMIT FOR
uAST E'6ATER COLLECTION Effective July1952 J61S TR:2U7ION SYSTEM
Effective 1952
# I Instructions: This form Is to be completed and submitted to the Department along
with one set of engineering plans and specifications, AT LEAST 30 DAYS PRIOR TO
INITIATING CONSTRUCTION. All blanks must be filled.
1 I. General Description
1. Person(s) or entity that will own the CS/05
Name and Title Candler Development Co.
5075 Roswell Hoak—
address Suite 110
Roswell , Georgia 30342
Phone ( ) 4o4 252-0660
2. CS/DS Description This system will be known as: Atlantic Village Center
This system will serve family homes, X commercial
facilities and multifamily units. Other:
Estimated Flow/Demand )(33tC�C(' 6po .
Th Ci^ty eofefAtlantic Beach,'.nlila ler plant serving this system will be
II. Stataent by Applicant
The undersigned owner or authorized representative' of Candler Development Co.
is fully aware that the statements made in this notice are true and complete to the
best of his knowledge. The undersigned is fully aware that it is his responsibility
to operate and maintain this facility in such a manner as to function as it was
designed. Responsibility may be transferred to another entity upon written notice to
the Department from the entity assuming respOnsib Iffy.
Signature of the O'sner or Authorized Representative
Attach a letter of Asa G. Candler , V - President
aunor;zation Name ana Title
`.-TAT = 404 252-0660
Date Telephone .vu-ger
III. Statement by Utility p > }
The undersigned states that �. [q /��/ &et L. treatment plant has
sufficient capacity to proviee ater/prinming water treatment to serve this
system mnen completed, that the treatment plant will operate in compliance with
Chapter 17-6/Chapter 17-22, and any other applicable regulations, that the facility
is not under a moratorium of any kind
Sign u �a Title
-;gn zC .pr�na Title ✓
/)4- 3e /9f) 9oY . 99 2395
Date jeiepnone bumper
IV. Statement by Engineer
This is to certify that the engineering features of this system have been designed by
me In accordance with Chapter 17-6/17-22 and any applicable local requirements. It
is also stated that the undersigned has furnished the applicant with written
instructions for the operation and maintenance of the system. A statemeot certifying
completion of the system and appropriate clearances will be submitted to the •
Department in order to obtain/approvalato place t.ee�syste//m in service.
!!/4".- ._/ f___
ciyna tare
(Affix Seal) 7805
Florida Regis:ret—or, Ncacer
904 - 386-3206
Date ieiepncne Nuacer
DER Fern 17-1.122(43)
U W
NOTICE CF IN:ENT TO YSE SEVERAL FERM!T FOR
X3S.XXXXXXXIXXXXOG S XNX/CR!hr.: ;D .AIER DISTRIBUTION SYSTEM
Effective July 1982 '
Instructions: This form is to be completed and submitted to the Department along
with one set of engineering plans and specifications, AT LEAST 30 DAYS PRIOR TO
INITIATING CONSTRUCTION. All blanks must be filled.
I. General Description
1. Person(s) or entity that will own the CS/OS
Name and Title Candler Development Co.
Address 5075 Roswell Road, N. E.
Suite 110
Phone ( ,10)4 zuzED6tifr3.1 , Gno--gia 30342
2. CS/DS Description This System will be known as: Atlantic Village Center
This system will serve family homes, X commercial
facilities and multifamily unl_ts,s Other:
Estimated Flow/ lWM-nd 20, 000 GPD
The olastewater treatment plant/or inkingater plant serving this system will be
_ City of Atlantic Beach , Fla.
II. Statement by Applicant
The undersigned owner or authorized representative' of Candler Development Co.
is fully aware that the state-Tents made in this notice are true and complete to the
best of his knowledge. The undersigned is fully aware that it is his responsibility
tO operate and maintain this facility in such a manner as to function as it was
designed. Responsibility may be transferred to another entity upon written notice tO
the Department from the entity assuming respons'ell ity. N.
/. �/
Signature o the O-,ner or Authorized Representative
',Attach a letter of Asa G. Candler, V, President
authorization Name and Title
/_,
/ : - /'-? �. 404 — 252-0660
Date / i elepnone Nu.moer
III. Statement by Utility T ]
The undersigned states that CST( c'rf //`7/v/' C �ra:c 4 treatment plant has
sufficient capacity to prov ice wastewater/cranking water treatment to serve this
system when completed, that the treatment plant will operate In compliance with
Chapter 17-6/Chapter 17-22, and any other applicable regulations, that the facility
is not under a moratorium of any kind. fyi //q/
- / k � /1� _ /G� (L/1
_ion cure and Title
0-C-C- 30 /Q PZ / 4z 9/91 1--
Date I elepnone Noma .
IV. Statement by Engineer
This is to certify that the engineering features of this system have teen Cesigned by
me in accordance with Chapter 17-6/17-22 and any applicable local requirements. It
is also stated that the unoersicned has furnished the applicant with written
instructions for the operation and maintenance of the systen. A statement certifying
completion of the system and appropriate clearances will be submitted to the '
Department in order to obtain approval to place the system in service.
l,e z_/
Signature
(Aff is Seal) 7805
rvarioa Registration Aumcer
904 — 386-3206
Date I elepncne NJ,moer
DES Fon 17-1.122(43)