HomeMy WebLinkAboutHYDRANT PERMIT - 21-00324 - Parks Department FHM 28' te<ck Velman
From: Natalie Powe
Sent: Friday, May 7
To: Chuck Velmar
Subject: Melaleuca car
Melaleuca contacts for snow removal:Agatha
801-671-2406
.Maralre Powell
Ciry o%1?III
Carle,Fq irrement Officer
(20dj 359-3020exr. 2163
RF BURG
35 North 1 st East
Rexburg, ID 83440
Date
FIRE HYDRANT USE PERMIT
NONTRADITIONAL WATER CUSTOMERS
Noah.phethean4rexburg.org Phone: 208.372-2136
www.rexburg.org Fax: 877.397.3917
Meter # 07t7Z * Z?
Permit #
Business name:��,rh ��✓/�s Q`� Phone #
Picked up by 1/7xq /I ;A 4 r -r Phone #
Address: (�e,
REXBURG
Amen.w Pomdv Camnumty
Hose Number:
Year Issued:
Deposit
amt: (Receipt Code=
WDEP) with credit cards charge an additional 3.5%
(Receipt Code= MISCG)
$1,800 -
2" Water Meter _L
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 15t East, before attempting to take any water.
2. Take water only from the one fire hydrant designated by the city water department.
3. Check out 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 V 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 water taken.
Signature P Applicant
REFUND TO:
METER OK: YES OUT READ
NO IN READ
GAL. USED
READ DATE
METER RE -ISSUED? YES/NO
Issued by:
CHARGES:
METER MAINT
0-1000 GAL
ADDITIONAL W ATER
REP AIRS -P ARTS
TOT AL
Received by:
75--- 00 --
10.00
(DRANT USE PERMIT
NTRADITIONAL WATER CUSTOMERS
rexburg.or
g ahone: 208.372-2136
o rexburg,org Fox; 877,397.3917
111 Meter # di
H— Hose Nu
Permit # 2( —I"I 2 u
Phoneme
e j Phone #
Lncc.ib UN �
� S year Issued: 2 '�—
Nith credit cards charge an additionaE 3.5% ERece
Deposit retained? or refunde0
n from backflow of the Rexburg city water syste,
ldrant must comply with the fo\lowing:
wrg City Hall, 35 N V East, before attempting
hydrant designated by the city water depaitn
in% device from the city water dept. to be at{
ty water deptment.
required on any metering device. Any da
ty use, repair, or replacement charges at
lCity water dept, wilt conduct a bnaE it
ugh the metering device is as Eolbws.
i0 Each 1,000 gallons thereafter : 5`-
1$75.00 maintenance tee for 2" will
211 for testing calibrations. A met
lis policy shall be assessed 1