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2073 Mayport Rd utility permit
CITY OF ATLANTIC BEACH s) 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 UTILITY SERVICE - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: UTIL18-0027 Description: outside COAB limits- new water/sewer tap request Estimated Value: 0 Issue Date: 4/9/2018 Expiration Date: 10/6/2018 PROPERTY ADDRESS: Address: 2073 MAYPORT RD RE Number: PROPERTY OWNER: Name: Address: 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. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. * A notice of Commencement is only required for work exceeding an estimated value of $2,500. For HVAC work, a Notice of Commencement is only required when HVAC work exceeds and estimated value of$7,500. Ut k A-- L J'� D City of Atlantic Beach PUBLIC UTILITIES DEPARTMENT 1200 Sandpiper Lane ?) Atlantic Beach, FL 32233 (404)247-5834 NEW WATER/SEWER TAP REQUEST Date Jam- 2 S-/ S Project Address 26 '73 �"1,q�L�0i2a 2p g� Number of Units Commercial V/" 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 MA_4 T LOP&IK& Z TWC Applicant Address 204© 1041 2D City. Au� s(gNo 1c- State—r-L- zip Z2-3 Phone t{ 'Z y .IfOS Cell '104 -2�'4-Y40r Email a,tr'a J_ c' bPSIS©U 1� Applicant Signature CITYSTAFF USE ONLY Application#6 Water System Development Charge $ 6, y 7& , 00 Sewer System Development Charge $ 2/9 Si?? , DU Water Meter Only $ 5 • QO Reclaim Meter Only $ Water Meter Tap $ Sewer Tap $ Cross Connection $ Za®- av Other 3/y. r2rzi�.�r;;�,v scrzv ict $ l 1 yc7 . o0 TOTAL $ 2�, -5-7 8. on (Notes) APPROVED Kayle Moore, P.E. ' '-rd's Date f � I Public Utilities Director or Authorized Signature ALL TAP REQUESTS MUST BE APPROVED BY THE PUBLIC UTILITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED