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• <br />=Prov ro U11/ ryletiers: <br />\Tft,ara G. Pinto /p Dide SWwd <br />Director of Utility Servioes <br />ermit Requirement'�"'�°� <br />I hereby Wknowledge trot I taw been Infwmerm <br />ed that a permit Is regalm <br />ed by the building Depasunt for the InstalIeUm <br />of tis eervke ens frwn the meter. Feilwe to obtain tMs pemtlt may rcsuh In a delay In the iraLllagon of ea meter. <br />A copy of this eprAcatbn will be tumishad to the Building Depuurard far their scolds. <br />��Z,P k C/,,ver : <br />customer Nema(Print) CustorneKgnatwe Date <br />WHITE • ORIGINAL YELLOW • CUSTOMER COPY PINK • BLDG. DEPT. COPY <br />INDIAN RIVER COUNTY <br />raua. . a <br />DEPARTIAW OF VnJN ew,vers <br />Sin to Family <br />[du�l=l/Commercial(Ph as® <br />Resldentlal/Comm (Addition) <br />1. Applicants Name:Phone <br />M: <br />2. Builders Name: <br />Phone k: <br />C <br />Applicable Codes: <br />3. Location/Street: <br />��— <br />(I.) Indian River County Utilities <br />% <br />c�.r.�� ;. .., — 41--)1 <br />P.".1 In a. <br />=Prov ro U11/ ryletiers: <br />\Tft,ara G. Pinto /p Dide SWwd <br />Director of Utility Servioes <br />ermit Requirement'�"'�°� <br />I hereby Wknowledge trot I taw been Infwmerm <br />ed that a permit Is regalm <br />ed by the building Depasunt for the InstalIeUm <br />of tis eervke ens frwn the meter. Feilwe to obtain tMs pemtlt may rcsuh In a delay In the iraLllagon of ea meter. <br />A copy of this eprAcatbn will be tumishad to the Building Depuurard far their scolds. <br />��Z,P k C/,,ver : <br />customer Nema(Print) CustorneKgnatwe Date <br />WHITE • ORIGINAL YELLOW • CUSTOMER COPY PINK • BLDG. DEPT. COPY <br />'°"^'For Office Use Only <br />Total q ERU's: <br />Unit Designation: <br />INDICATE BY CODE) <br />Applicable Codes: <br />��— <br />(I.) Indian River County Utilities <br />Water (V,) City of Vero Beach <br />Sewer <br />(F.) Franchise Utility <br />(N.) No service is available from any source <br />f'l <br />130- <br />Water Impact Fees <br />ERU's @ $'-57680 Each <br />I�p, <br />$ <br />Water Service Connection <br />I SVC @ $ Each = <br />$� <br />5/8: @ $400.00 <br />- 1 Inch @ $460.00 <br />1 1/2lnch @ $610.00 <br />Water Deposit <br />:_�Deps @ $50.00 per ERU <br />$ <br />I <br />Water Inspection <br />Fee @ $25.00 Each = <br />$ <br />Meter Installation <br />SVC @ $ Each = <br />$ <br />5/Bloch @ $130.00 <br />=loch @ $200.00 <br />9 1/21nch @ $500.00 <br />Water Lyne Extension Fee <br />FT @ $11.25 / FT = <br />$ <br />Sewer Impact Fees <br />ERU's @ SB q ,000E Each = <br />$ <br />Sewer Lateral <br />Taps @ $500.00 Each <br />$ <br />rte.... <br />Copp 9. 50.00 Fu, EFIU = <br />$ <br />Sewer Inspection <br />Fees @ $25.00 Each = <br />$ <br />Sewer Line Extension Fes _FT <br />@ $15.77 / FT <br />Court R�!cording Fee <br />= <br />$__ <br />Total Balance Due: _ <br />$ w S3 t1S� <br />=Prov ro U11/ ryletiers: <br />\Tft,ara G. Pinto /p Dide SWwd <br />Director of Utility Servioes <br />ermit Requirement'�"'�°� <br />I hereby Wknowledge trot I taw been Infwmerm <br />ed that a permit Is regalm <br />ed by the building Depasunt for the InstalIeUm <br />of tis eervke ens frwn the meter. Feilwe to obtain tMs pemtlt may rcsuh In a delay In the iraLllagon of ea meter. <br />A copy of this eprAcatbn will be tumishad to the Building Depuurard far their scolds. <br />��Z,P k C/,,ver : <br />customer Nema(Print) CustorneKgnatwe Date <br />WHITE • ORIGINAL YELLOW • CUSTOMER COPY PINK • BLDG. DEPT. COPY <br />