HomeMy WebLinkAboutFIRE HYDRANT PERMIT 2 - 20-00379 - Rexburg Rapids #6UrYNlntt� or,
Mitres
shouldn Pt'inr to die.
t.+rrry
r,� Pnnr
-...,, to the sun
Nater Nheq
the
� nth suit -
0 surf
ern
to env s to
sepa-
qn lu mg/L
"'u the
shall
stpt�Rr,
reel to
taA P.
p To:
Y OF REXP
rtch - 314_—
W Heyre
o Falls,
METER PLIBT
MTR R9ot
6rWIRE
2 FOR Col
7H10
&
Resir
PROPEI
f�
L
=1in FgM6, l
FIRE HYDRANT USE PERMIT
NONTRADITIONAL WATER CUSTOMERS
I 35 North Ist East Noah photheonarexuurg.urg Phone: 208.372.2136
l Rexburg, ID 83440 www,rexburg.org Fox: 877.397.3917
Date
Business name:
Meter # F FF I"� b
Permit # 2D- /V2> 9
Phone #
Picked up by fil e IAot, J Phone #
Address:
c r oIF
REXBURG
Ow
4em n;,G r"mely GVMrri4rlr(y
Hose Number:
Year Issued: )DZti
Deposit amt: (Receipt Code= WDFPJ with credit cards charge an additional 3.5% (Receipt Code= MISCG)
$1,800 - 2" Water Meter_ Deposit retained? or refunded?
$ 800 - 1" Water Meter ( date)
CONDITIONS OF PERMIT:
In order to prevent possible contamination from backflow of the Rexburg city water system, any persons or entity
desiring to obtain water from a city fire hydrant must comply with the following:
1. Obtain a written permit from Rexburg City Hall, 35 N 1" East, before attempting to take any water.
2. Take water only from the one fire hydrant designated by the city water department.
3. Checkout the backflow and metering device from the city water dept. to be attached to the fire hydrant
agreed upon by the user and the city water deptment.
4. As indicated above a deposit will be required on any metering device. Any damage to or loss of the device
will be paid for by the user. After any use, repair, or replacement charges are deducted ,the balance of the
deposit will be refunded to the user. (City water dept. will conduct a final inspection.)
5. The fee for any water obtained through the metering device is as follows:
Fee: 1-1,000 gallons $10.00 Each 1,000 gallons thereafter: $5.00
6. A $50.00 maintenance fee for 1" and $75.00 maintenance fee for 2" will be assessed each year for
maintenance on the meter.
7. The meter needs to be returned by 12/1 for testing calibrations. A meter can be reissued the same day per
request if needed.
Any person or entity not complying with this policy shall be assessed a penalty charge of $400 in addition
to the normal charge for the waterlltakep '\ A I eoee
REFUND TO:
METER OK:
re of Applicant
YES OUT READ / % G tV
NO _ IN READ 2102
GAL. USED
READ DATE _
METER RE -ISSUED?
YES / NO
CHARGES:
METER MAINT
0- 1000 GAL
ADDITIONAL WATER
REPAIRS -PARTS
aivari Inv• X& .
75.00
10.00
ILAM
tky and
Inic
VA v2u
� We
avice
of the
Y per
tion