Referenced in Title IV § 4.02 and Appendix A
| Name | |
|---|---|
| Service Address | |
| Phone | |
| Item | Amount |
|---|---|
| Tap Installation | $3,500.00 |
| Meter Fee | $900.00 |
| Deposit | $300.00 |
| Total Due |
Applicant Agreement: I agree to comply with all provisions of the City of Mingus Code of Ordinances Title IV and to pay all fees and charges when due.
Signature: _______________________ Date: ____________
City Verification Initials: ___________ Date: ___________