2010_0114T K C - C { T Y O F
COPPELL
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UNW!
A 6 �
METER ISSUANCE / WORK ORDER
Account Number.
r>atr: I ki I /a 0 (Q Company/Repmsentative:
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B Ming Account Name:
Billing Address: Kb C-SLIA� S2 City- State: Zip Code:
Signature: 4
00
Domestic Mtr . ,1 . # 1 �%���
JJ
Size: 3 / q it
Reading
Deposit Amt �-
Domestic Mtr. #
Size:
Reading
Deposit Amt
Irrigation Mtr. #
Size: Reading
Deposit Amt.
Irrigation Mtr. #
Size: Reading
Deposit Amt
Fire Line Mtr. #
Size: Reading
Deposit Amt.
Fire Line Mtr. #
Size: Reading
Deposit Amt_
Temporary Mtr. #
Beginning Reading
Deposit Amt
TEMPORARY METERS• $1 000 DEPOSIT REOUIR.ED
Applicant shall return the meter to 916 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 constriction 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 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`b 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 $
D� , n Cl�-PI?A0ES .