1251 SELVA MARINA CIR UTIL18-0052 CITY OF ATLANTIC BEACH
3 r 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
i 0 INSPECTION PHONE LINE 247-5814
UTILITY SERVICE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: UTIL18-0052
Description: new irrigation meter request
Estimated Value: 0
Issue Date: 8/29/2018
Expiration Date: 2/25/2019
PROPERTY ADDRESS:
Address: 1251 SELVA MARINA CIR
RE Number. 171913 0000
PROPERTY OWNER:
Name: BUDNICK TODD S
Address: 370 12TH ST
ATLANTIC BEACH, FL 32233-5437
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: EASTERN SHORES CONSTRUCTION
Address: 1015 ATLANTIC BLVD#240
ATLANTIC BEACH, FL 32233
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
1 exceeds and estimated value of$7,500.
i
UT I L19- 0052
AUG 21 AM City of Atlantic Beach
I , PUBLIC UTILITIES DEPARTMENT
re BY; _ 902 Assisi Lane
Jacksonville, FL 32233
(904)247-5834
NEW WATER/ SEWER TAP REQUEST
,�.�//tt
Date )`b Service Address an
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 �a oriL aril�jj '�+a n.` elm,
BillingAddress S,21', �Lr; v.� GrcAe-
City w h ic-.^E`•� Ao- State rt- Zip `32.23 3
Phone - S�^'I I e
Email C�r,S f�6N or-hle�y� �j,
Applicant Signature 62 4�2
CRY STAFF USE 15FLY
Application A (4-114- - I g - 00 T Z
tAT
Water System Development Charge $ '� N� NU✓
�o csn�
Sewer System Development Charge $ .0'
Water Meter Only $ '�
Reclaim Meter Only $ Y`
Water Meter Tap $ G�
Sewer Tap $ , /(0 9
Cross Connection $ So• o0
Other $
TOTAL $ �� G/ _ (Notes)
APPROVED Kayle Moore, P.E. �Ltl/� Date J 2Y14'/�( t'
Public Utilities Director or Authorized Signature
ALL TAP REQUESTS MUST BE APPROVED BY THE PUBLIC UTILITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED