2013_0426T H 1: C ` T Y 6 F AcGOu at 1'e=ber:
COFFELL
r �
IvEE 1 ISSUANCE / WORK ORDER
Date: 2 20 3 Companyae- pmsentative: r/6 im h wcs
projDct Name: LsT I L S Of I� -
Location. of Meter Ce f Y 9 W 1 5201 f 1 ChM �i
is n -r-� �
Bthing Account name: m2 i/ L/u m Es
Billing Address: aePg '-)A l..L'1-S 6K41 "/ ��City: � y State: _ Zip code: 7svg3
Phone 9: 71�
Printed Name: —W—xt -1 ac M 7SZ8�
�S Signature: '
11�
i Il •
Irrigation Mtr. #
Fire Line Mtr.
Fire Line Mtr. #
Size: � Reading
O
Size: �_ Reading
n
Size: Reading
Size: Reading
Size: Reading
Size: Reading
Deposit Amt
Deposit Amt.
Deposit Amt -
Deposit Amt_
Deposit Amt.
Deposit Amt.
Temporary Mtr. 9 Beginning Reading Deposit Amt
TEMPORARY METERS• $1 000 DEPDSIT RECTJIIZED
Applicant shall return. the meter to 816 S. Coppeu 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 temporafy constr ruction 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 Ci t ire I1 ydrants may be
used. Customer must call 972 -462 -5150 to report a reading. Tbc City is not responsible for any stolen property under
any conditions.
The City will deposit the $1,000 upon receipt rre
The cunt, 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 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 $ Sewer Tap $ Meter $ Final Inspection $