2012_1217I T Y O F
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METER ISSUANCE / WORK ORDER
Date: I%— l — �— Comgany/Representative: i C M A
Project Name: MA 44 N T
Location of Rueter.
Billing Account Named
Billing Address: 0 • /�%!> City: 6)9 State: Zip Code: Ol
Phone #: /� 1�� / J� -1 �l Y U U D.L. �: " S �b (cal
Printed Name: Signature:
Domestic Mtr. ri /i24 S �U � Size: J � Reading
Deposit Amt,, '
Domestic Mtr. # Size: Reading Deposit Amt
Irrigation Mir. # Size: Reading Deposit Amt-
Irrigation Mir. # Size: Reading Deposit Amt
Fire Line Mtr. # Size: Reading Deposit Amt
Fire Line Mtr. # Size: Reading Deposit Amt-
Temporary Mtr. ## Beginning Reading Deposit Amt
TEMPORARY METERS $1 ODD DEPOSIT REQUIRED
Applicant shall return the meter to 816 S. Coppell Road when completed with project Cast 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 construction 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 jobsfprojects. Only yellow City Fire Hydrants may be
used. Customer must call 372 -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 l,DDO 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 due by the 5e' of each raanth. If payment is not received by this
date, tbere will be a penalty of 10% accessed to the total balance.
Tap � -110 �°, ,
Water T $ Jb Sewer Tap $ 4y Meter $ Final Inspection $ U