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EFFECTIVE DATE: Hydrant Use Permit Application Development Engineering PLEASE CHECK SERVICE AREA: TYPE Redmond Service Area TYPE Novelty Hill (UPD) Service Area TYPE Submit application with backflow prevention device test certificate (for types A and C) to: [EMAIL REDACTED] Office Use Only DATE RCV’D:________________ACCEPTED Applicant Name & Billing Address (required) (Type B Only) Truck or Container Vessel Company Name: Applicant Address: City: State: Zip: Contact Phone # Email: Billing Email: Redmond Business License Sweeper Truck Water Truck Truck License Number: Truck License Number (If container vessel holds 500 gal. or less one permit can cover a maximum of 2 trucks. Permit must be displayed in each truck) (Type C Only) meter reporting Meter reads (all 7 digits) must be reported NO LATER THAN THE 5th DAY OF EACH MONTH On permit issuance, the City of Redmond authorizes the applicant to obtain water from hydrant situated at : Project Name: Water Use Purpose: Job Site Location: THE UNDERSIGNED AGREES TO HOLD HARMLESS the City of Redmond, its officers, agents and employees from any and all claims or liability of any nature whatsoever for injury to or death of any person or damage to any property real or personal , arising out of or occa- sioned on any manner by use of a City of Redmond hydrant. Print Name: Date: Signature: Hold harmless agreement FROM THE DATE THE PERMIT IS ISSUED, all water billed to be paid for in accordance with Ordinances of City of Redmond relating thereto. A administration fee and daily water rate, based on type of permit will be charged regardless of completion of any required truck inspections. PERMIT MUST BE DISPLAYED IN TRUCK(S) OR ON JOB SITE AT ALL TIMES. CANCELATION: and daily water charges will continue to accrue UNTIL WRITTEN NOTIFICATION IS RECEIVED CANCELING THIS PERMIT. Due care must be exercised in operating the hydrant; permit holder will be responsible for any damage occurring to hydrant or any equipment connected therewith.