1631 Mayport Rd new water tap/sewer request CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
UTILITY SERVICE -
MUST CALL BY 4PM FOR NEXr�AY INSPECTION: 247-5814
RIERMIT INFORMATION:
PERMIT NO: UTIL17-0018
Description: new waterlsewer tap request for new house
Estimated Value: 0
Issue Date: 9/1/2017
Expiration Date: 2/28/2018
PROPERTY ADDRESS:
Address: 1631 MAYPORT RD
RE Number: 1720720000
PROPERTYOWNER:
Name: CONSELICE JOSEPH J JR TRUST
Address: 209 OAK DR 8
FLEMING ISLAND, FL 32003
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name:
Address:
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
A notice of Commencement is only required for work exceeding an estimated value of
$2,500.For RVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
Cash Register Receipt Receipt Number
19 City of Atlantic Beach R2445
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $5,990.00
UTIL17-0018 Address: 1631 MAYPORT RD APN: 172072 0000 $5,990.00
PUBLIC UTILITIES $5,990.00
WATER SYSTEM DEVELOPMENT IMPACT 415-0000-324-0301 $1,140.00
CHARGE i
SEWERSYSTEM DEVELOPMENT CHARGE 415-0000-324-0301 1 $4,050.00
WATER METER AND TAP 3.3302 o $800.00
TOTAL FEES PAID BY RECEIPT: R2445 $5,990.00
Date Paid: Friday,September 01, 2017
Paid By: CONSELICE JOSEPH J JR TRUST
Cashier: BA
Pay Method: CREDIT CARD 11
Printed:Friday,September 01,2017 2:43 PM 1 of I
Pv (AT-IL-iq - ooi s'
City of Atlantic Beach
PUBLIC UTILITIES DEPARTMENT
1200 Sandpiper Lane
AUG 2 a 2017 Atlantic Beach, Fl. 32233
ci ) (904)247-5834
NEW WATER SEWER TAP REQUEST A06 2M7
Date Sb-'3113: Project Address 10'ItO
Number of Units Commercial Residential Multi-Family_
New Water Tap(s) &Meter(s) Meter Size(s)
New irrigation Meter_ Upgrade Existing Meter from—to (size)
New Reclaim Water Meter Size New Connection to City Sewer
Applicant Name
Applicant Addre uo'
city 'k State Zip ��-Z-Z
Phone � —4
Email -1 AD C7 ��J,
Applicant Signature
CITYSTAFFUSEONLY
Application#
Water System Development Charge $ uqc'� �. o
Sewer System Development Charge $ !�'
Water Meter Only 0!
Reclaim Meter Only 0
Water Meter Tap $ ffly C)-
SewerTap $ 0
Cross Connection $ 0
Other $ 0
TOTAL '4�; q 1 (Notes)
APPROVED Kayle Moore,P.E. 14/� Date
Public Utilities Director a,Authorized Signature
ALL TAP REQUESTS MUST BE APPROVED BY THE PUBLIC UTILITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED