New Project Information Submittal - FORM



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NEW PROJECTS: PROJECTS INFORMATION/SUBMITTAL SHEET

Please e-mail this completed form to Lee County Utilities - Attn: Mary McCormic at mccormmm@, or (Terry Kelley (kelleyta@) a minimum of 7 business days prior to submittal to Lee County Utilities. Fees will be calculated based on the information provided herein. Lee County Utilities personnel will complete an ‘Estimated Fee Quote’ showing the calculation of fees to be pre-paid upon submittal. The completed ‘Estimated Fee Quote’ will be e-mailed back to you, to be included in your submittal packet.

* Please be sure to include a .pdf of the construction plans and a copy of the Engineer’s Probable Cost Opinion.

Date: 9/25/15

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|Project Name: |      |# : | |      |

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|Strap Number: |      |

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|Location: |      |

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|Project Description: |Choose all that apply. |

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|Water |Potable Water Distribution System |Water Main Extension |Fire Lines Hydrants |

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|Sanitary |Gravity Collection System |Force Main |Lift Station* |

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|Reuse |Reuse Main Extension |Reuse Meter Station | |

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|Other |Water Service(s) |Sewer Service(s) | |

|Type of Use: | |Number Of Units: | |Number of ERC’s: |

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|S/F Residential | |      | |      |

|(Individually Metered Homes/Units) | | | | |

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|M/F Residential | |      | |      |

|(Master-Metered – More than 1 Home/Unit per meter) | | | | |

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|Commercial (Describe on page 2) | |N/A | |      |

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|Industrial (Describe on page 2) | |N/A | |      |

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|Other (Describe on page 2) | |N/A | |      |

*Note: Be sure to include one (1) ERC/Unit to water for each lift station.

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NEW PROJECTS: PROJECTS INFORMATION/SUBMITTAL SHEET

PROJECT NAME:     

Further instructions for Commercial, Industrial, Other:

Show a detailed description of water consumption for commercial, industrial, or any other type of development by using F.A.C. 64 E-6 guidelines for each meter. Note, the total of these flows should be equal to the Total Average Daily Flow included on the Department of Health and/or the Department of Environmental Protection construction permit applications. We have included a worksheet (page 3) to assist in completing this section.

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Please calculate total number of ERC based on above GPD divided by 250 GPD (1 ERU) for the total ERUs.

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List number and sizes of water meters required for this development. Please include what each meter will serve.

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* Please be sure to include a .pdf of the construction plans and a copy of the Engineer’s Probable Cost Opinion.

Page 2 of 4

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Lee County Utilities

Commercial Worksheet

Please fill out the appropriate fields for your project.

Basic Business Information:

Project Name:      

Strap#(s):      

Type of Business:

Total Square Footage:       S/F Office:       S/F Warehouse:      

Number of Restrooms:     Number of Employees per 8-hour shift:    

(Toilets/Urinals)

Additional Information by category:

Please Note : Only most common categories are shown below. Additional information may be required. Please refer to Chapter 64E-6 of the Florida Administrative Code.

• Warehouse:

Warehouse – Number of Loading Bays:      Number of Self-storage Units:     

• Doctor and Dentist Offices:

Number of Practitioners: (in addition to other employees)    

• Food Operations (Restaurant, Bar/Cocktail Lounge, etc.):

Operating Hours:      

Total Number of Seats:      Restaurant:      Bar/Cocktail Lounge:     

Number of pool tables or video games:     

• Hotel & Motel:

Number of Rooms:      Number of cottages:     

Laundries/Number of Machines:     

Page 3 of 4

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NEW PROJECTS: PROJECTS INFORMATION/SUBMITTAL SHEET

PROJECT NAME:     

Developer Information:

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|Name of Developer &/or Owner: | |      |

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|Name and Title of Representative: | |      |

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|Mailing Address: | |      |

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|City, State & Zip: | |      ,          |

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|Telephone Number: | |(   )   -     Ext.     |

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|Fax Number: | |(   )   -     |

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|E-mail Address: | |      |

Engineer Information:

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|Name of Engineering Firm: | |      |

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|Name of Project Engineer: | |      |

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|E-mail Address: | |      |

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|Alternate Contact Person: | |      |

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|E-mail Address: | |      |

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|Mailing Address: | |      |

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|City, State & Zip: | |      ,          |

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|Telephone Number: | |(   )   -     Ext.     Alternate: (   )   -     Ext.     |

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|Fax Number: | |(   )   -     |

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