HomeMy WebLinkAboutHYDRANT PERMIT 2 - 22-00516 - Mountain Valley Construction FHM 3035 North Ist Post
Rexburg, ID 93110
Business name:
HYDRANT USE PERMIT
NONTRADITIONAL WATER CUSTOMERS
Nooh.phelhenn6rexburp, orp
www rexburp.org
Phone: 209.372.2136
Fox: 877,19139 11
Meter # UtL
Per It #
rK Phone #
RIMURG
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Picked up by Phone # A 7 Moo aoq�111``613
Address: vM! <_oca�lonr `^m pe�1�` Year Issued: _Z"Lzr_
Deposit amt: (Receipt Code= WDEEP) with credit cards charge anIdditional 3,5% (Re(pipt Coder MISCG)
$1,800 - 2" Water Meter y Deposit retained? orrefunded?
$ 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 Hell, 35 N 1i1 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 licy shall be as ssed a penalty charge of $400 in addition
to the normal charge for the water to%"
REFUND TO:
METER OK: YES OUT READ
NO IN READ
GAL. USED
READ DATE
METERRE-ISSUED? YES/NO
6 V
Issued by: 4 �
CHARGES:
MI TFR MAINT
0 1000 GAL
ADDITIONAL WATER
REPAIRS -PARTS
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