2011_0330Date: -3 /3 0/11
G / T Y O R
COFFELL
4 T �
A 6 �
Account Number.
METER ISSUANCE / WORK ORDER
Company/Representative: 5 A-V I Q (, '9f " dY f f flsw�? t3�z* c S. ,• i'�
Project Name: 1,CY A J a (YA t a y /tY
Location of Meter. 5-Y K / G t h—S ✓ `(
Billing Account Name: n A4-V I n W ed X LC-f /- dT
Billing Address: 3 3 o l AI..Z = 3S- City. State. rx Zip Code: 7 S"0
Phone#: (l d ) 502-7012 D.L. #: 1 & 3 63 0 3
Printed Name: GeJ t-� /2 - 5kn rw Signature: "o-00, zf
Domestic Mtr. # - 7,126 )l
Domestic Mir. #
Irrigation Mtr. #
Irrigation Mtr. #
Fire Line Mtr. #
Fire Line Mtr. #
Temporary Mir. #
Size: Ring
Size: Ring
Size: Rig
Size: Ring
Size: Ring
Size: Ring
Beginning Reading
Deposit Amt. y
Deposit Amt:
Deposit Amt.
Deposit Amt.
Deposit Amt.
Deposit Amt.
Deposit Amt.
TEMPORARY METERS- $1.000 DEPOSIT REOUIRED
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 temperatures.
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 properly 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 I VY6 accessed to the total balance.
Water Tap $ Sewer Tap S Meter $ Final Inspection S
74