2013_0430Date. 30 Z O L 1-
T K m - C F T Y O F
ISSUANCE / FORK ORDER
CorzrgaFiylRepresentative:
Account Number:
\/i6 A�zQA
Project Marne: �v c
ral c- ►� i 1`i 2
Location of Meter: 9 12
Billing
Account r?aaae: �- �- t �
Z .eC14 C-riy :''s i c�e��cn.. � d�t� Staie:� � dip Cade:
Billing Add,°ess: 1
gr7Z 2 Z i D.L. tt
Phone. ✓ i, A h3- Signore:
printed Name: V
'Amt
Reading
DDme� ` G Mtr.
Domestic Mtr. #
Size:._— Reading
6l
lrri gate . a Mtr.
��5�(OV't Size: _ Reading
Size: Reading
irrigati.an NItr. #
Size: __— Reading
Fire Lire Mtr.
Fire Line Mtr. #
Size: _ -- Reading
Temporary httr. #
Beonning Reading_ -
Deposr€
Deposit Amt —
Deposit Amt-
Deposit Amt _—
Deposit Amt
Deposit Amt-
Deposit Amt
TEW- ORARY METIERS• $1 DDD DEPOSIT REQUIRED
Applicant shall return the meter to 8I6 S. Coppell went or deductedfromdthe deposit- of any repairs or
replacements necessary shall be billed one temporary
Apphcant is responsible fop winterizing canctton meters and components to protect them against any
darn e due to freezing temperat�s' ellow City Fire Hydmots May be
Customer is not allowed to mo-462- -5150 of ereportea treading.. The City is a responsible for any stolen property under
used. Customer must call 972
any conditions.
The City will deposit the $1,000 upon receipt_ The current, minimum monthly wafer bill shall be $48.40, whicl
includes the first 1,000 gallons used. All wafer in is due by f the 5mgof each znanth- If payym 1,000 is D t received by thi hl
charges are subject to changof 10 accessed to the total balance.
date, there will be a penalty
Water Tag $_— Sewer Tap $__
Meter $ Final Inspection $.__ ---