Townhouses-WO020326WATER ISOLATION REOU~,ST A-N]P~R METER RELOCATION
Tune: ~,~.'.2 $~
Area Affectcd (St~ Blo~ No.):
DATE REQUEST IS
Tim~ off: a.mJp.~n.
Tim~ on: ~m/p.nL
Water Main $i~: Inches
water Service: Inches
If watcr customers of thc system ~ be affected, contractor ~h~ll provide a list ot'eaclx ~dxosc busincsscs or
~csidcmial suucturcs affcctcd.
*Note: The ~t~ of Coppell Utili~ Division shall perfom all water line shut-downf. Contractors are not
Date:
FOR METER RELOCATION ONLY:
Date: ~-2&' Er2- Amount of Payment:
* (AP. ach woflc order for relocation only.)
Initials:
~ ~ P.O, BOx 478
Coppell, Texas 75019
~__/~ ~---"~ 214-304-3545
Name '' --,r'~: _ ~,. .... ; /1~_
Service Addre~ '
Date '~2G'''0~. Cash Check No.
WATER TAP / METER INSP. FEE
SEWER TAP INSP. FEE
UTILITY FINAL INSP. FEE
SECURITY DEPOSITS-WATER
WATER / SEWER SERVICE SALES
WATER METER SALES REVENUE
WATER TAP FEE
SEWER TAP FEE
CUSTOMER SERVICE INSPECTION
BACKFLOW DEVICE REGISTRATION
BACKFLOW DEVICE TESTED REGISTRATION
METER TEST FEE
2 2 3 9 TOTAL
Received By