2865 Mayport Rd UTIL18-0050 water & irrigation meter request \N ,
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-S814
PERMIT INFORMATION:
PERMIT NO: UTIL18-0050
Description: new water& irrigation meter request
Estimated Value: 0
Issue Date: 7/27/2018
Expiration Date: 1/23/2019
PROPERTY ADDRESS:
Address: 2865 MAYPORT RD
RE Number:
PROPERTY OWNER:
Name:
Address:
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Summit Construction Mgmt. Group
Address: 421 Sout hSummerlin Avenue
Orlando, FL 32801
Phone:
PERMIT INFORMATION:
Please see aftached 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.
J:� i
�A T a L I ? -OCD,�
City of Atlantic Beach
PUBLIC UTILITIES DEPARTMENT
902 Assisi Lane
Jacksonville, Fl. 32
�33
(904)247-5834
NEW WATER SEWER TAP REQUEST JUL 18 2018
Date Service Address 25&1� 1Y,4VP0P--T PD . BYL-�
Number of Units Commercial Residential Multi-Family_
New Water Tap(s) & Meter(s) Meter Size(s) 2
New Irrigation Meter -Z Upgrade Existing Meter from to (size)
New Reclaim Water Meter Size New Connection to City Sewer
Applicant Name-'�M IV] 101-T UIV37744LION Mbl"'T GPOIAE
Billing Address 514MMQ?-WA1 A-06-. -D gi^D 6 EL 3 Z,, 6
City State Zip
Phoneh 0 q ) -2-7 0— 10)1!0S
Email SD A/, W M W 17 C M 6)P&W CZYO
Applicant Sign atu re
CITY STAFF USE ONLY
Application#CjT I L 9 OD 5-0
Water System Development Charge $ 3. 79(P
Sewer System Development Charge $ V&LQ)
Water Meter Only $ 3300 . 00 FA,�A
Reclaim Meter Only $
Water Meter Tap $ -
Sewer Tap $ -f #ff
Cross Connection $ C9<,i
Other $
TOTAL s 1-7 00 (Notes)
APPROVED Kayle Moore, P.E. Date
Public Utilities Director or Authorized Signature
ALL TAP REQUESTS MUST BE APPROVED BY THE PUBLIC UTILITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED
INVOICE #
City of Atlantic Beach INV-4965
800 Seminole Road Date Due: 8/23/2018
Atlantic Beach, FL, 32233
Summit Construction Mgmt. Group
421 Sout hSummerlin Avenue
Invoice Date:7/24/2018
Record# Record Type Fee Group Fee Description Quantity Amount
UTIL18-0050 UTILITY SERVICE PUBLIC UTILITIES CROSS CONNECTION 1 $50.00
WATER METER ONLY 0 $330.00
DOMESTIC
WATER SYSTEM 1.5 $3,796.00
DEVELOPMENT IMPACT
CHARGE
$4,176.00
Invoice Total:$4,176.00
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C7- C AA-
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Please send your payment to this address:
10.0
Printed:Tuesday,July 24,2018 11:15 AM 1 of 1
Cash Register Receipt Receipt Numb
City of Atlantic Beach R5828
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $4,176.00
UTIL18-0050 Address: 2865 MAYPORT RD APN: $4,176.00
PUBLIC UTILITIES $4,176.00
CROSS CONNECTION 400-0000-343-3701 1 $SO.00
WATER SYSTEM DEVELOPMENT IMPACT 41S-0000-324-0301 2 $3,796.00
CHARGE
WATER METER ONLY DOMESTIC 400-0000-343-3301 0 $330.00
TOTAL FEES PAID BY RECEIPT: R5828 $4,176.00
Date Paid: Tuesday, July 24, 2018
Paid By: Summit Construction Mgmt. Group
Cashier: JJ
Pay Method: CREDIT CARD 020599
00-
01
Printedi Friday,July 27,2018 10:43 AM 1 of I I
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