Prestwick-WO040331C1TY OF COPPELL
WATER UTHJTIES
WATER ISOLATION REQI~EST AND/OR METER RELOCATION
The followin~ information must be provided in order m allow isolation of any pa~ of the City of Coppell Water
Sys~.m. This form mus~ be comple~d and submiv,~d to th~ Utilities Division for proce,ssi~ tw~nly-fonr (24) hon~
pdor to ti~ ,~t. ~he isolation is tuque, ed.
q ) 3 c/ - 0
DATE REQUEST IS HEEDED: /~ ~°D... [ /..
Timeoff: I ]; tl~)O ~,Ip.m.
Time on:
wa~r M~i. Size: Inches
Water Sc~icc: Inches
If wa~er customers of the sysmn will be afl'~ted, conWactor Ihlll provide a list of each of those busi~_ _~s or
*Note: The Cit~ of CoppeH Utilities Division shall perform ~ll water line shut-dowus. Contractors are not
Si~t:
l~im-~me: .~,~,F~-' ' '~ ~Y~O Y
FOR METER RELOCATION ONLY:
Da~e: ...... Amount of Payment:
* (AVach work order for relocalion only.)