1951 Beach Ave UTIL18-0054 utility request Cash Register Receipt Receipt Number
19 City of Atlantic Beach R7247
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $3,5 M�"
UTIL18-0054 Address: 1951 BEACH AVE APN: 169695 0000 $3,593.00
PUBLIC UTILITIES $3,593.00
WATER SYSTEM DEVELOPMENT IMPACT 415-0000-324-0301 0 $764.00
CHARGE
CROSS CONNECTION 400-0000-34�3701 0 $50.00
SEWER SYSTEM DEVELOPMENT CHARGE 415-0000-3244)301 0 $2,7".00
WATER METIER ONLY DOMESTIC 400-0000-343-3301 0 $35.00
TOTAL FEES PAID BY RECEIPT: R7247 $3,593.00
Date Paid: Friday, November 02,2018
Paid By: FLEMING MATTHEW DAVIS
Cashier: LE
Pay Method: CREDIT CARD 5
Printed:Friday,Nwember 02,2018 2:21 PM I Of 1
ECEIVE CITY OF ATLANTIC BEACH
800 Seminole Road
OCT 2 2 2018 Atlantic Beech,Florida 32233
REVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS
Date [�j teki I yr Revision to Issued Pernnitl--�C'rrectionsto Comments— Permit# U7-ILIS-0051
ProjectAddress Hsi B15MA
Contractor/Contact Name
Phone Email
Description of Proposed Revision/Corrections: Permit Fee Due$
(110 klq 1'n q Meier 3�-Lc' 4D
j '-j
Additional Increase in Building Value Additional S.F.
By signing below,I affirm the Revision is inclusive of the proposed changes.
(printod nane)
signature of Contractor/Agent(Contractor must sign if increasc in valuation) Date
(Office Use Only)
Approved Denied Not Applicable to Department
Revision/Plan Review Comments AVI--
Department Review Required: ;71—
Building 14
Planning &Zoning —7 Reviewed By
Tree Administrator
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44L)k�Utih�be
Public Safety ate
Fire Services
City of Atlantic Beach
PUBLIC UTILITIES DEPARTMENT
902 Assisi Lane
Jacksonville, FL 32233
(904) 247-5834
NEW WATER SEWER TAP REQUEST
Date Service Address 1�5
'6ea(hke.
3 ,9 033
NumberofUnits Commercial Residential Multi-Family 011611
New Water Tap(s)&Meteris) Meter Size(s)
New Irrigation Meter_ Upgrade Existing Meter from to (size)
New Reclaim Water Meter Size New Connection to City Sewer
Applicant Name 7e<u
Billing Address 16a�s j�ezA-Awlliae,
city W&A�A I State zip
Phone lqo 4) 6 5 1 — 'C�&1 7 Z _F'o 3
Email et�"
Applicant Signature
CITYSTAFFUSEONLY
Application# itri L_ I
Water System Development Charge
Sewer System Development Charge s
Water Meter Only
Reclaim Meter Only
Water Meter Tap
Sewer Tap $
Cross Connection nin
Other
TOTAL (Notes)
APPROVED Date
Public Utilities Direct�or Authorized Signature
ALL TAP REQUESTS MUST BE APPROVED BY THE PUBLIC UTILITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED
vt —F 'I- I- 17- ocE�f
City of Atlantic Beach
PUBLIC UTILITIES DEPARTMENT
5EP 4 2018 902 Amisi Lane
Jacicsonville,Fl. 32Z33
(904)247-5934
NEW WATER SEWER TAP REQUEST
Date ServiceAddress 1951 r-�
Number of Units Commercial Residential Multi-Family_
New Water Tap(s)&Meter(s) MeterSize(s)
New Irrigation Meter_ Upgrade Existing Meter from L314 " to / YZ (size)
New Reclaim Water Meter— Size New Connection to City Sewer_
AppliuntName bayis a&U,Q,
Billing Acidness_Za2 5 &Zillz 299�
city &IM-k 9UM State R- zip
Phone /904 //7,52- 5�o??
Email 1111pn4l,kia a samZrail?,
Applicant Signature
CITY STAFF USE ONLY
Application 9 f4-T I L 1 00 5;4
Water System Development Charge 2, & 5&, 00
Sewer System Development Charge VJ 7 , oo
Water Meter Only
Reclaim Meter Only $
Water Meter Tap $ /15-, 00
Sewer Tap $
Cross Connection $ se) , no
other $
TOTAL $ /2, 33S . on (Notes)
APPROVED Date
Public Utilities Director or Authorized Signature
ALLTAP REQUESTS MUST BE APPROVED BY THE PUBLIC UTILITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED