HomeMy WebLinkAboutUTILITY SERVICE INFORMATION;_�_J -CVJ�W ic; "yj r rom�
Port St. Lucie Utility Systems Department
Utility Service Information
Telephone: (772) 873-6400 Email: UtilEng@cityofpsi.com
Submit completed worksheet, applicable plans and fees. SCANNED
BY
Business Name, St. Lucie County
1. Project Name:. (2--, A [)Z"d
Plaza Name: 1�d ?'a4g Z41 I" A2 Cl
(SType Of Establishment: _KPS4wajLL Square Footage:
(Be Spabific: i,e., Restaurant, Dortor's Office, Real Estat,e Office,
Applicant: (Owner of Business)
,N N a rn a: V b r—,* Title:
C4. Service Address Of Facility:
Include Bay/Suite Number Street Address "y/SulteiNumber
A 7- 4y Z_
city st�;7 zip
ype Of Service Requested. (Check appropriate boxes)
Water Wastewater Fire Protection irrigation
Propoted 0 N/A
Existing El
El
Fire Line Required: Yes. El If Yes, Indicate Line(s) And Slze(s
No
ater Meter Upgrade: YES rJ NO rl
07interior Changes/Upgrades: YES (plans included and will be retained by PSL USD5 NO 0
�.F a Included:$
I
FQR PSitJSQ QEEJG9_VAL2_N1,y_
k�
rojeol Name: File No.: Pub -File No.:
By: Date:
ERD's Reserved:— FRC's used — hislodral: (attooh historical)
rEffeeiive Date;10/01/2013 PSLUSD Doc No. 116
11ti)l �-Cqfyi�O-Tnf^lma rion Pan 0
Re C e i ve d iiiie 'May. 6, 2015 10:53AM No. 2M '
:Huw-. �a-4� rrome
I
Utility Service information
roPosed Hours
Of Operation:
Monday;
j:L30 AM to
crP PM Friday; i� AM:.to
PM
Tuesday:
j�, AM to
PV PM Saturday: AM;to
PM
Wednesday;
AMto
PM Sunday: AMAO
PM
� 30
Thursday;
AM to
PM
Itlow Derivation (Select only One Category — A or B or C or D)
ck the appropriate category used to determine the ERC flows for your projeot ;
*A. Estimated by the PSLUSD: The applicant ran defer to the PSLUSD to eal i imate water usage.
S. Historical ERC Data based on current usage: See our historical f w use instructions
Section 61.11(g) of the City Code.
Calculated EROS: (attach all historical data) I
El C. Fixture Unit Method: See the Florida Plumbing Code fixture r fixture units.
Total ERC Value Number of Fixture Units
20
Fixture Units—� 20 ERCs
El D. ERC Determination Table: See our ERC Determination Table for ERC factors.
Section 61-11 of the City Code,
Type of Establishment (Per ERC Table,):
Applicable "Units";— No. Of Beds,
Square Feet:— No. Of Seats:_ (including bar & outcl ! 0or seating)
Employees; Total No._ Per Shift Shifts per Day_
Other:
ERC Factor: x Units = ERCs
By my signature below, I acknowledge that approval of this application may result In a
modification to the Utility Service Agreement for this -property and may require property
improvements and the payment of addf!jpnal fees. 1
(Owner of Business)
Received Time May. 6, 2015 10:53AM No. 2535 2 Of 2
Doc No. 116