1600 Selva Marina Drive 16-COTH-1705 (Water & Sewer Tap Request) -S r\J�l N.
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`s J CITY OF ATLANTIC BEACH
__ ;) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
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INSPECTION PHONE LINE 247-5814
COMMERICAL ALTERATION/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-COTH-1705
Job Type: COMMERCIAL OTHER
Description: Pete's Turn new water and sewer meter, approved for
payment only
Estimated Value:
Issue Date: 7/28/2016
Expiration Date: 1/24/2017
PROPERTY ADDRESS:
Address: 1600 SELVA MARINA DR
RE Number: 169399-0000
PROPERTY OWNER:
Name: ATLANTIC BEACH PARTNERS, LLC
Address: 414 OLD HARD RD SUITE 502
PERMIT INFORMATION:
FEES:
SEWER SDC-SYSTEM DEV $21,587.00
CHG
WATER CONNECT/TAP & $390.00
METER
WATER CROSS CONNECTION $50.00
WATER SDC-SYSTEM DEV $6,076.00
CHG
Total Payments: $28,103.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
-S�Lvrr ( G - C ilEl,J q sy
,.4 `. `i, CITY OF ATLANTIC BEACH
PUBLIC UTILITIES
J4v 1200 Sandpiper Lane
ATLANTIC BEACH,FL 32233
P-1,0 ii WI' (904)270-2535 or(904) 247-5874
NEW WATER/SEWER TAP REQUEST
Date: l/2 t I f 6 Project Address: 16 00 S&C1/09 M4- ,'Nn
No. of Units: I Commercial 7' Residential Multi-Family
/r
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 y
Name: 1) C
Applicant Address:
City: State: Zip
Phone Number: Cell Number:
Email Address Fax:
Signature:
(Applicant)
CITY STAFF USE ONLY
Application#
Water System Development Charge $ 6'/ 8 7 ( 1j 6010"1eGz-uo J (a/F-0
Sewer System Development Charge $ 2(/ Se 7 ®RI tdl4�
Water Meter Only $ ,3 9 0 su&r�`/` � / G.
Reclaim Meter Only $ r /1A-t F
Water Meter Tap $ (notes)
Sewer Tap $ Wee Cross Connection $ Sa DW IZ Stt B Itr i�( 1) i4
Other $ e M- IT S&L'S. N Z`r
TOTAL $ ,18fID3 C.p'`''d2 ,1) I
APPROVED: Kavle Moore, PE 'ti'"(Deputy PW Director or Authorized Signature)
ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES
CAN BE ASSESSED