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Townhouses-WO060105~ OF COPPELL WATER UT~JTIES WATER ISOLATION REQUEST AND/OR METER RELOCATION The following informnfion must be provided in order to allow isolation of any pan of the City of Coppell Water System. This form must be completed and submitted to the Utilities Division for processing twenty-four (24) hou~ taior to the date the isolation is mtuested. Ar~a Aff~'t~d (Sueet, Block No.): DATE REQUEST IS NI~I~r~ED: Watof ~ain Si~: ~ IIlch~ Water Service: Inches If water customers of the system will be affected, contractor ~hall provide a Est of each of those busin~ses or *Note: The City of Coppell Utilities Division shall perform all water line shut-downs. Contractors are not permitted to turn any v~lves in the system. / ContractOr Representulive FOR METER RELOCATION ONLY: Dato: '-~'"4-0(~ Amount of Payment: * (Attach work order for relocation only.)