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C <br />INDIAN RIVER COUNTY au owm.ut <br />DEPARTMENT OF IIn try SUMIAS <br />uukvvP­lsgnaa _ <br />Single Family I Multi/Commercial (Phased) —� I Rosidential/Comm fAddilion) <br />1. Applicants Name: 6(�i�rltiPp )o.j Phone N:( X60 882 -83s8 <br />2. Builders Name: Phone#: 779-2-4,6 <br />3. Location/Street: G US / ''// <br />e Subdivision: ParcollD#:45_3 :L;37 0,9 00 700Pd000TQ <br />""""'For Office Use Only <br />Total # ERU's: <br />Unit Designation:_ <br />INDICATE BY CODE _ Applicable Codes: <br />Water (I.) Indian River Countv Utilities <br />(V.) City of Vero Beach <br />Sewer (F.) Franchise Utility <br />(N.) No service is available from any source <br />Water Impact Fees ERU's @ $t-- BEach = <br />/900,00 <br />t� <br />$ L?00.00 <br />Water Service Connection SVC @ $ Each = <br />5/B Inch @ ca0n On <br />$ <br />1 Inch @ $460.00 <br />1 1/2 Inch @ $810.00 <br />Water Deposit L+' Deps @ $50.00 per ERU = <br />$ <br />Water Inspection Fee @ $25.00 Each = <br />$ Jc •00 <br />Meter Installation SVC @ $_1,2D.wEach = <br />$ 3(700 <br />5/Bloch @ $130.00 <br />1 Inch @ $200.00 <br />1 1/2 Inch @ $500.00 <br />Water Una Extension Fee FT @ $11.25 / FT - <br />$ <br />Sewer Impact Fees ERU's @ $2:590 Each = <br />X7c?&, b O <br />$ <br />Sewer Lateral Taps @ $500.00 Each = <br />$ <br />Sewer Deposit :—Dops @ $50.00 Per ERU = <br />Sewer Inspection Fees @ $25.00 Each = <br />$ <br />Sewer Llne Extension Fee FT @ $15.77 / FT = <br />$ <br />Court Recording Fee = <br />$ <br />Total Balance Due: _ <br />$� �55 <br />Approved for Utility Matters: <br />-N 1a,aa�b� Z PG <br />SouaAeo-firPhNo Date signed <br />Director of Utility Services <br />RRp"*"'Permit Requirement"""*"" <br />I hereby acknowledge that I have been irdwried that a permit is required by the Building Department for the Installation <br />of the service Ilns horn the meter. Fallure to obtain this parmit may result In a delay In the Installation of the ureter. <br />A copy of this application will be furnished to Um Building pep r their records. <br />Cuslomer Narnfi (Print) Customer Sip r Dale <br />WHITE - ORIGINAL YELLOW -CU MER COPY PINK- BLDG. DEPT. COPY <br />