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Water /Wastewater Annexation

2. WATER/ WASTEWATER ANNEXATION
   USE THIS FORM TO: Request the City Commission’s authorization to extend water and/or sanitary wastewater services to property not located within the City limits and not currently eligible for annexation. This form also includes a Petition for Annexation, as required by Municipal Code prior to the extension of services outside the City’s jurisdiction.

   USE THIS FORM TO: Request the City Commission’s authorization to extend water and/or sanitary wastewater services to property not located within the City limits and not currently eligible for annexation. This form also includes a Petition for Annexation, as required by Municipal Code prior to the extension of services outside the City’s jurisdiction.

4. Fees

   1. $300

6. IMPORTANT NOTES
   Per Municipal Code Sections 82-44 and 82-403, the extension of City water and/or sanitary sewer services to property located outside the municipal limits must be authorized by the City Commission. Application for these services shall be placed on the next available City Commission agenda. The City Commission meets the 1st and 3rd Tuesday of each month at 6:00PM. Applications must be received three (3) weeks prior to the requested agenda.

   Per Municipal Code Sections 82-44 and 82-403, the extension of City water and/or sanitary sewer services to property located outside the municipal limits must be authorized by the City Commission. Application for these services shall be placed on the next available City Commission agenda. The City Commission meets the 1st and 3rd Tuesday of each month at 6:00PM. Applications must be received three (3) weeks prior to the requested agenda.

8. PROPERTY INFORMATION
   Property information can be found at the Nassau County Property Appraiser’s Website → Map Search

10. Site Address*

12. Parcel ID #(s)*

14. OWNER OF RECORD
    As recorded with the Nassau County Property Appraiser

    As recorded with the Nassau County Property Appraiser

16. First Name*

17. Last Name*

19. Company (if applicable)

21. Mailing Address*

23. Telephone Number*

24. E-mail Address*

26. OWNER'S AGENT
    If an agent will be representing the owner, an Owner’s Authorization For Agent Representation form must be included

    If an agent will be representing the owner, an Owner’s Authorization For Agent Representation form must be included

28. First Name

29. Last Name

31. Company (if applicable)

33. Mailing Address

35. City

36. State

37. Zip

39. Telephone Number

40. E-mail Address

42. PROJECT INFORMATION

44. Total Number of Lots/Parcels*

45. < One (1) acre sq. footage*

46. > One (1) acre sq. footage*

48. Existing Zoning Classification*

49. Existing Future Land Use Classification*

51. Description of Request*

53. Certification*

    1. By signing below, I certify that the information contained in this application is true and correct to the best of my knowledge at the time of the application.
    2. I acknowledge that I understand and have complied with all of the submittal requirements and procedures.

55. Applicant's First Name*

56. Applicant's Last Name*

58. Today's Date*
    Today's Date

59. Upload Supporting Documentation*

61. Upload 2

62. Upload 3

63. Upload 4

64. Upload 5

66. 

68. DEPARTMENT OF PLANNING & CONSERVATION
    204 Ash Street | Fernandina Beach Florida 32604 | 904 310-3480 | www.fbfl.us/planning

    204 Ash Street | Fernandina Beach Florida 32604 | 904 310-3480 | www.fbfl.us/planning

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70. 1. Receive an email copy of this form.
71. Email address

    This field is not part of the form submission.

72. Submit Submit and Print

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