2012_0621Late:
Project Name:
Location of Meter.
21( 2012
itl e7 A T 1
T H C
COFPELL
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METER ISSUANCE / WORK ORDER %
Campany/Representative: cn J
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Account Number.
Billing Account Name:
Billing Address: I�r� Sc%1JCktAEZk City: Asti State: 7x- Zip Code:
Phone #: ` 7�"
ryi
D.L. #:
Printed Name:
Signature:
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2- Size: Reading ( Deposit Amt
Size: Reading 2 Deposit Amt.
# 2 `�q4- Size: Reading ' Deposit Amt-
tr. 6 Size: tl Reading ( Deposit Amt
Fire Line Mtr. 4 Size: Reading Deposit Amt
Fire Line Mtr. # Size: Reading Deposit Amt.
Temporary Mtr. # Beginning Reading Deposit Amt
TEMPORARY METERS $1 00D DEPOSIT REQUIRED
Applicant shall return the meter to 916 S. CoppeU Raad 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 jobsJprojects. 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 waxer 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 50' of each month. If payment is not received by this
date, there will be a penalty of 100/0 accessed to the total balance.
Water Tap $ Sewer Tap S Meter $ Final Inspection $