22 Seminole Rd UTIL18-0040 new meter permit s' CITY OF ATLANTIC BEACH
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: UTIL18-0040
Description: new 3/4" meter-22 & 28 SEMINOLE RD
Estimated Value: 0
Issue Date: 6/11/2018
Expiration Date: 12/8/2018
PROPERTY ADDRESS:
Address: 22 SEMINOLE RD
RE Number: 170655 0000
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.
aty of Atlantic Beach
:. ; PUBLIC UTILITIES DEPARTMENT
1200 Sandpiper Lane
Atlantic Beach, FL 32233
D0Z+ (904)247-5834
NEW WATER/SEWER TAP REQUEST i 7 , e (e-
-7
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Date 6-23 -I $ Project Address 0 2 d 7"W- 0 t'UD[-S �FnOD.
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
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CITY STAFF USE ONLY
Application# Ll 11 t- S(
Water System Development Charge $
Sewer System Development Charge $
Water Meter Only $
Reclaim Meter Only $
Water Meter Tap $ f�cp' Oy
Sewer Tap $
Cross Connection $ ' DO
Other $
TOTAL 9 650, OIC (Notes)
APPROVED Kayle Moore, P.E. 164v�. Date �27
Public Utilities Director or Authorized Signature
ALL TAP REQUESTS MUST BE APPROVED BY THE PUBLIC UTILITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED
Cash Receipt s� Register
City of
DESCRIPTION
• CITY PAID
PermitTRAK $850.00
UTIL18-0040 Address: 22 SEMINOLE RD APN: 170655 0000 $850.00
PUBLIC UTILITIES $850.00
CROSS CONNECTION 400-0000-343-3701 1 $50.00
WATER METER AND TAP 400-0000-343-3302 0 $800.00
TOTAL1 1 11
Date Paid: Friday,June 08, 2018
Paid By: DORSCH SALTAIR PROPERTIES LLC
Cashier: BA
Pay Method: CHECK 5751
Alp
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