2013_0211Date: – 31-6 1
T H E C [ T Y C F
COFFELL
ZA
� c
e e a
b t 1 ER ISSUANCE / WORK ORDER
Company/Representadve: �J/kt%F�
Proje.Rt Name: --1 -� /4T
Location of Meton 7 5�k I t Il i
Account Nmnber.
Billing Account Name: ' 1-t^ iT•:s i
Billing Address: 0 /(, '9' (' o PP64" City: �a^ .�iF�I/ Staie7k__ Zip Cade:
Phone 9: (0/4T 819 37 33 D.L. 9: rX
Printed Name: .h h(>l� -! h Sign
210 rdur nea u
Domestic Mtr.
ome5uthmtr. #
Irrigation Mtr. �
Irrigation Mtr. 9
Fire Line Mtr. #
Fire Line Mtr. 9
Temporary Mtr. 9
1)
Size:
Size:
Size:
Size:
Reading / DD
Reading
Reading
Reading
Reading
Size: Reading
Beginning Reading
Deposit Amt ''-
Deposit Amt.
Deposit Amt
Deposit Amt
Deposit Amt-
Deposit Amt_
Deposit Amt
TEMPORARY METERS $1 000 DEPOSIT REQUIRED
Applicant shall return the meter to 816 S. Coppell Road when completed with project Cost of any repairs or
replacements necessary shall be billed on the final statement or deducted from the deposit_
Applicant is responsible for winterizing all temporary conslructian meters and components to protect them against any
damage due to freezing temperatures.
Customer is not allowed to move or relocate a meter to different jot7sfprojects. Only yellow City Fire Hydrants may be
used. Customer must call 972 -462 -5150 to report a reading. The City is not responsible for any stolen property under
any conditions.
The City will deposit the $1,000 upon receipt The current, minimum monthly water bill shall be $48.40, which
includes the first 1,000 gallons used. All water in excess of 1,000 gallons will be $2.60 per 1,000 gallons. (Minimum
charges are subject to change.) Monthly payment is dice by the 5m of each month. If payment is not received by this
date, there will be a penalty of 10% accessed to the total balance.
Water Tap $ Sewer Tap $ Meter $ Final Inspection $