HomeMy WebLinkAboutHYDRANT USE PERMITS - 23-00682 - Big D Construction FHM #170 P
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35 North Est East
Rexburg, ID 83440
Date Issued
IN
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Business name. •
Picked up by;
Address: '
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FIRE HYDRANT USE PERMIT
NONTRADITIONAL WATER CUSTOMERS
Noah.phethean@rexburg.org
►vww.rexburg.org
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Phone: 208.372-2136
Fax: 877.397.3917
Meter # 17
Permit #
f- > - 051�#j ;,�, OR 4*:7�
Phone #
Phone # 20-3,
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CITY O F
RExB%uRG
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Amcrlcns Family Community
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City State Zip: ��a�l�o 7�!/S cGalb �3,5/02 Year �cc Issued: Zo�3
Deposit amt: (Receipt Code= WDEP) with credit cards charge an additio $2,f500 - 2" Water Meter nal 3.5% (Receipt Code= MISCG)
Deposit retained or refunded?
$ 800 - 1" Water Me -ter x td/00,
CONDITIONS OF PERMIT: (date)
In order to prevent possible contamination from backflow of the Rexburg cit wat
desiring to obtain water from a city ire hydrant must comply with the following:er system, any persons or entity
1• Obtain a written permit from Rexburg City Hall, 35 N 15C East, before attempting
Z. Take water only from the one fire hydrant designated by the city water department.
g to take any water.
3. Check out the backfiowand metering device from the city water dept. to beagreed upon by the user and the city water deptment.0
attached to the fire hydrant
4. As indicated above a deposit will be required on any metering device. Anywill be paid for by the user. After any use, repair, or replacemen damage to or loss of the device
deposit will be refunded to the user. (City water de t, t charges are deducted ,the balance of the
5• The fee for any water obtained through the pW��� conduct a final inspection.)
metering device is as follows:
Fee: 1 —1,000 gallons $10.00 Each 1,0�0 gallons thereafter
6• A $50.00 maintenance fee for 1"and $
maintenance on the meter. 75.00 ma'$5•00
maintenance fee for 21-0 will be"'assessed each year for
7. The meter needs to be returned by 12/1 for testing
calibrations. A meter can bereissued the sarequest if needed,me day per
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.ell
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Kt t- UND TO:
METER OK.-
Issued by;
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NO
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UU I READ
iN READ
GAL. USED
READ DATE
METER RE -ISSUED?
27.0
YES / NO
cant
CHARGES:
METER MAINT
0-1000 GAL
ADDITIONAL WATER
REPAIRS -PARTS
TOTAL
Received by:
10600
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