2012_11060-�M WRI
Projer^t Name: _
Location of Meter:
T K M - C E T Y - a_ F
V
C FE
r e
13SUANCE / WOR_K GRIPER
Compary/Represeatat ve:
i vi,AA at Dmim
.�CCAiL7t �`eLIIb°r -..
Billing Account Name: e so u a e- � �' e-- ma Of fZ e 119 1 -"A� C
Billing Address:. 302 3 SPn�NS cl R /��Tj�i CitY: AR /IAA State: �� Zip Code: 75-;LS-54
Phone I : (6'!72 1 SRO • 6 Sec D.L.
Priuted Name:, /3 as 7;c, Signature:
Domestic
Mtr-4.
I
Size:
2- U
Reading
Deposit Amt
Deposit Amt
Domestic
Mtr. it
Reading D
Size:
Fil-re Line Mtr. It S
Reading
Deposit Amt.
Deposit Amt
lrrigatiou Nltr. - S
Size: 2
2 tt Reading D
Deposit Amt -
Irrigation Mtr. f, S
Size: R
Reading D
Deposit Amt
Fire Line Mtr. # S
Size: R
Reading D
Deposit Amt
Fil-re Line Mtr. It S
Size: R
Reading D
Deposit Amt
Temporary Mtn r B
Begimiinz Reading D
Deposit Amt-
EMPORARY METERS• $1.00D DEPOSIT REOU`EZED
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 constrUction meters aad compone i s to protect them against any
damage due to freezing tempmratures.
Customer is not allowed to move or relocate a meter to different jobsiprgjects. 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 monthiy 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 due by the 5`' 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 $ (OD • 1 Sewer Tap S �k-_
Meter $ �• Q�
X 2�
DO
Final lnspection $