HomeMy WebLinkAboutHYDRANT PERMIT - 21-00245 - RZ Contractors Inc. FHM 235 North 1st Eos+
Rexburg, ID 83440
Date Issued
Business name
Picked up by
Address:
FIRE HYDRANT USE PERMIT
NONTRADITIONAL WATER CUSTOMERS
Noah PhelheanUrexburg.org Phone, 208.372-2136
www.rexburg. org Fax: 877.397.3417
i I Meter p Hose Number
Permit q .2
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Year Issued: 202A
Deposit amt: (Receipt Code= WDEP) with credit cards charge an additional 3.5% (Receipt Code= MISCG)
$10800 - 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
to the normal
charge
for
the water�tak#.
REFUND TO:
METER OK: YES
NO
Issued by:
S
OUT READ
IN READ
GAL. USED
READ DATE
METER RE -ISSUED? YES/ NO
of
be assessed a e of 540 ►addition
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CHARGES:
METER MAINT
0- 1000 GAL
ADDITIONAL WATER
REPAIRS -PARTS
TOTAL
Received by:
75.00
10.00
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