2012_0605gate: ( - 5 , 2012
Project Name: cull
Location of Meter.
Billing Account Name:
B Ming Address: P L
T M C - C [ T Y O F
C01F1 ELL Account Number.
T �
METER ISSUANCE / WORK ORDER
Company/Repmsentative: al 12�1
Phone 4: (J1 ) 'Z2 6
Printed Name: 44- L7�e� / 1 /l —LYe �
Domestic Mtr. 4
Domestic Mtr. #
Irrigation Mtr. # o r-�q
Irrigation Mtr. # _(�l �-)-
Fire Line Mtr. 4
Fire Line Mtr. 9
City: L4k �� State: Zip Code:
Signature:%
Size:
Reading
Size:
Reading
Size:
2 Ll
Reading Q-7
Size:
Z U
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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 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 construction meters and components to protect them against any
damage due to freezing tzmperatures.
Customer is not allowed to move or relocate a meter to different jobs /projects. 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 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 lnspection $