HomeMy WebLinkAboutHYDRANT PERMIT 2 - 21-00316 - Rexburg Rapids FHM 8D
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FIRE HYDRANT USE PERMIT
NOWRA IIONAl WATER CUSTOMERS
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Prnone:
208.372-2136
kexbui� �J 83440
wII rexborg org
Fox:
877.397.3917
Date Issued Iv Meter#
Permit #
Business name: G 4k <i tze f Hks k0jnL e,ti' Phone #
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Picked up by Ax)X Phone #
1
Address: i2eilr"_,,. ' )s
Year Issued:
( I Ty OF
RFMURG
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.amenias tamrh com.ruimty
Hose rvurnuent• 1
F(uS Hll-eea�'I
Deposit dmt: (Receipt Code= WDEP) with credit cards charge an additional 3.5% (Receipt Code= MISCG)
Water $1,800-2"WatMeter ✓
5 Deposit retained? or refunded?
S 800 -1"Water Meter
cd NDIr,ONS OT PERMIT: ( date)
,n order to prevent possible contamination from backflow of the Rexburg city waters stem, an
` den'r,ne rn obtain water from a dtV fire hydrant mu
1. Obra„' a t) wat' y Y persons or entity
Take Pe CI from Rex must comply with the following;
3 w+ter only fk�� the burg City Hall 35 N 1” East, before attempting o take do w
chwck our the b one Ree hydrant d ptln t
4sin 11 n usf And merenn Of"
by the city water department. Y Ater.
Yee d d+�+ dehe pos and cn y waterrdeptment, cIYV water dept. to be attached to the
wxq
be
ota sn w/Nbeany rby �wdser Aher required an any metering device,PP*ir orHee hydrant
s. Th efu y useIt e Lis,
103% Of the
A SSO Upm rnf n®n�O�allons 5lO ughrthR mwto�eR dwlt c ductca fl sl �e dsductedr.the balenze pflYe
malen' ce fee for Each 1, Ce is as fn/toN s• WlcflOn) he
The ance on the meter. 1 F and $7500r"4
nellonsfthef eafter : 5.S.op
nce
An request' ro be returned by 12/1 for 8 Calibrations'
apbr ee for 2' be far
velli as3esced
las t!n path
etiO Year
• c} j la th person or entity not c0 ns. A meter
e norma/ ch mplyin cin be reiffuatl the
charge for the wale taken. th ihis policy shalt be assessed
day per
Sassed a penalty charge of S400 in adgiti
RE'
,LEI �rrER O� p; �Si nature tet A � t -._..-. �r►
YES` Q - ".
READ
NP�-- - IN READ
GAL. USED CHARGES.
READ DATE ```---�..,.., METER �A-�-."
'METER'r�pp �NT
q .�.� p.1 ..,..
lV0YES/GASNo DDI
RQNAI WATER EPAIRS PARTS ER
Rec,p'Ved by 'TOTAL
00,10 41
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