HomeMy WebLinkAboutHYDRANT PERMIT - 20-00823 - Thompson Excavation & Asphalt Inc FHM #5ork Order: #12694
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Submitted To: Harper, Ivan
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$181.44
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IInt Date: 10/30/2020 1
35 Northlst East
Rexburg, ID 83440
Date issued
Business name
Picked up by
Address: ?O
FIRE HYDRANT USE PERMIT
NONTRADITIONAL WATER CUSTOMERS
Noah,phetheon@rexburg.org Phone: 208.372-2136
www.rexburg.org Fax: 877.397.3917
Meter #
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CITY OF
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,modca} Family Community
Hose Number:
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Phone #
Phone # 0�
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�. 2020
Deposit amt: (Receipt Code= WDEP) with credit cards charge an additional 3.5% (Receipt
�_ Code=MISCG)
$1,800-2 " Water Meter— Deposit retained. ( date)
$ 800 - 1" Water Meter
CONDITIONS OF PERMIT:
!nation from b
In order to prevent possible contamackflow 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. 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.
ny metering
4. indicated above
terequired paraor replacement charges are ice. Any damage to or deducted I
will
balance of the
will be paid for by the user. After any
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
An„ nprson or entity not complying vv
request if needed.
th this policy shall be assessed a penalty charge of $400 in addition
REFUND TO:
METER OK:
YES. UT READ
NO IN READ
GAL. USED
READ DATE
METER RE -ISSUED? YES/NO
issued by: 6`i &
CHARGES:
METER MAINT
0-1000 GAL
ADDITIONAL WATER
REPAIRS -PARTS
TOTAL
Received by:
75.00
10.00
Director