2814 & 2816 SHANGRI LA DR UTIL17-0029 UTIL SERV PERM UTILITY SERVICE PERMIT PERMIT NUMBER
7)
UTIL17-0029
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 3/26/2019
119 EXPIRES: 9/22/2019
9 ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA 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:
UTILITY SERVICE 2814 & 2816 Shangri La $0.00
Drive - outside city limits
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
COMPANY: ADDRESS: CITY: STATE: ZIP:
AMERICAN CLASSIC 3481 St Augustine RD JACKSONVILLE FL 32207
HOMES LLC
ADDRESS: CITY: STATE: ZIP:
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 CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
CROSS CONNECTION 400-0000-343-3701 1 $50.00
SEWER SYSTEM DEVELOPMENT CHARGE 41S-0000-324-0301 0.7S $4050.00
WATER METER ONLY DOMESTIC 400-0000-343-3301 0 $18S.00
WATER SYSTEM DEVELOPMENT IMPACT CHARGE 41S-0000-324-0301 0.75 $1140.00
TOTAL: $5,425.00
Issued Date: 3/26/2019 1 of 2
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City of Atlantic Beach
PUBLIC UTILITIES DEPARTMENT
OCT 2 5 2017 902 Assisi Lane
Jacksonville, Fl. 32233
.-Will (904) 247-5834
OC' 6 2017 NEW WATER/ SEWER TAP REQUEST '(e"� _CC)DD
Datq����/ 7 Service Address
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 rft gej dAiV- 1�k k4-S S �4olyL e--
BillingAddress ST-
city JqL"'05\j 'f )i-� C—: State 1:::L zip
Phone qoz/- 3t/
Email S�C-42 n'i (::�tc C_ . rk-4-
Applicant Signature
CITY STAFF USE ONLY
Application# (A71L I? - 0009 6),
Water System Development Charge $ If PZ 80 . oo C
Sewer System Development Charge $ I (a) , on
Water Meter Only s 370 . oc)
Reclaim Meter Only $
Water Meter Tap $
Sewer Tap $
Cross Connection $ 100-00
Other $
TOTAL $ to 66 0 , 00 1 (Notes)
APPROVED Kayle Moore, P.E. vvk— Date
Public Utilities Director or Authorized Signature
ALL TAP REQUESTS MUST BE APPROVED BY THE PUBLIC UTILITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED