HomeMy WebLinkAboutHYDRANT PERMIT - 20-00697 - Sethco Inc FHM #2935 North I st East
Rexburg, to 83440
Date Issued_ /
Business name:
Picked up by
Address:
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FIRE HYDRAWT USE PERMIT {o,.t;�°��,, CITY OF
NONTRADITI NAL WATER CUSTOMERS e ; 1�V1\G
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Noah.phetheonGrexburg. Phone: 208.372.2136 Anuw"iS ramfly tbmnamdY
www.rexburg. Fox 877.397.3917
LPermit#
er # q Hose Number:
tctL Phone # �d X630 4VG
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Deposit amt: (Receipt Code= WDEP) with cr
$1,800 - 2" Water Meter De
$ 800 - 1" Water Meter
CONDITIONS OF PERMIT:
In order to prevent possible contamination from ba
desiring to obtain water from a city fire hydrant mu
1. Obtain a written permit from Rexburg City 1
2. Take water only from the one fire hydrant (
3. Check out the backflow, and metering devic
agreed upon by the user and the city water
4. As indicated above a deposit will be require
will be paid for by the user. After any use, r
deposit will be refunded to the user. (City it
5. The fee for any water obtained through the
Fee: 1-1,000 gallons $10.00 Ear
6. A $50.00 maintenance fee for 1" and $75.(
maintenance on the meter.
7. The meter needs to be returned by 12/1 fb
request if needed.
Year Issued:
,ards charge an additional 3.5% (Receipt Code= MISCG)
retained? or refunded?
( date)
s
C I T Y O F
XBURG
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A Famdv Community
Public Works
Water Department
35 North 1v East
Rexburg, ID 83440
(208) 354-3020
Information
-- er, Ivan Lnuf
—
kflow of the Rexburg city water system, any persons or entity try9,2020 11:19am : Ct comply with the following: ll, 35 N In East, before attempting to take any water. : `signated by the city water department. r, Ivan : ifrom the city water dept. to be attached to the fire hydrant nber 17, 2020 11:30 am r.deptment. 1. Chuck r.I on any metering device. Any damage to or loss of the device iter shop (pair, or replacement charges are deducted ,the balance of the e
;iter dept. will conduct a final inspection.)
Test/Repair Int
Metering device is as follows: $56.70 $o.00
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1,000 gallons thereafter -. $5.00 ud°° press
maintenance fee for 2" will be assessed each year for $0.00
calibrations. A meter can be reissued the same day per
56,70
Any person or entity not complying with this pc icy shall be assessed a penalty charge of $400 in addition fie"
to the normal charge for the water taken. MID sic
{{ n aw c
Si tune of Applicant 1t�
REFUND TO:
METER OK: YES OUT READ CHARGES:
NO IN READ METER MAINT 75,00
GAL. USED 0-1000 GAL 10.00
READ DATE ADDITIONAL WATER
METER RE -ISSUE ES 0 REPAIRS -PARTS
6
TOTAL ._
'
Issued by: Received by:
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