2073 MAYPORT RD IRR METER PERM UTILITY SERVICE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH UTIL19-0012
J V~ 800 SEMINOLE ROAD ISSUED:
ATLANTIC BEACH. FL 32233 EXPIRES:
MUST CALL INSPECTION • • • 1 PM FORDAY • •
ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' ! + BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
2073 MAYPORT RD UTILITY SERVICE Irrigation Meter $0.00
TYPE OF
• • GROUP:
• ADDRESS:
MAYPORT LODGING 21NC 2040 MAYPORT RD
• ADDRESS:
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF . . •
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 PUBLIC UTILITIES UNDERGROUND WATER SEWER UTILITIES INFORMATIONAL
Notes:
Avoid damage to underground water and sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field
coordination is needed,call 247-5878.
2 PUBLIC UTILITIES METER BOX SEWER CLEAN OUT INFORMATIONAL
Notes:
Ensure all meter boxes,sewer cleanouts and valve covers are set to grade and visible.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
WATER METER ONLY DOMESTIC 400-0000-343-3301 0 $185.00
Issued Date: 1 of 2
UTILITY SERVICE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH UTIL19-0012 E
V" ISSUED:
800 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES:
TOTAL: $185.00
Issued Date: 2 of 2
City of Atlantic Beach
PUBLIC UTILITIES DEPARTMENT
902 Assisi Lane
J Y Jacksonville, FL 32233
(904) 247-5834
NEW WATER / SEWER TAP REQUEST
Date 2 �Q Service Address 20 1 J 4 j2OK+
Number of Units Commercial Residential Multi-Family
New Water Tap(s) & Meter(s) Meter Size(s)
r--
y
New Irrigation Meter `'' Upgrade Existing Meter from to (size)
New Reclaim Water Meter Sizel '`� New Connection to City Sewer
Applicant Name d K �-`�l
Billing Address d 0
City q , [ � State Zip
[
Phone l.�`'� ^ ` qbs
Email
Applicant Signature
I CITY STAFF USE ONLY
Application # 07[ L2-
Water System Development Charge
Sewer System Development Charge $
Water Meter Only $
Reclaim Meter Only $
Water Meter Tap $
Sewer Tap $
Cross Connection $
Other c $
TOTAL ,gcJ` O v (Notes)
APPROVED - ��w Date
,,f
lic Utilities Director or Authorized Signature
ALL TAP REQUESTS MUST BE APPROVED BY THE PUBLIC UTILITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED