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04-12-2010 CC agenda packet item_Water Service Agreements
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04-12-2010 CC agenda packet item_Water Service Agreements
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CITY OF LA PORTE PLANNING DEPARTMENT <br />604 west Fairmont Pa isway, to Porte, TX 77571 <br />Phone: 281471.5020. Fax: 2814705005 <br />wwN.Wponeb.9ov <br />APPLICATION for WATER 1 SEWER SERVICE to COMPANIES <br />WITH AN INDUSTRIAL DISTRICT AGREEMENT (IDA) <br />1.1 COMPANY NAME (per Applicant's IDA w/ DWI <br />Company Address: <br />- City Use only - <br />Ra'dby; Dose: <br />Time of Initial Review Meeting: <br />Date of fi temel Review Meeting <br />Request Mats Policy Guidelines?: Y or N <br />Date ot'Nusificmion to Company: <br />2.) `SITE TENANT (d other than "Company"): <br />Company Name: <br />Contact Name: <br />3) PROPERTY DATA (If available indude any survey, plat site Plan map or sketch of the subject site with this form): <br />`Company's Industrial District Agreement No.: 2007 — IDA - <br />'SiteAddress: <br />Site HCADID(s): --- --- --- --- --- --- -- _ <br />Total Site Acreage (Per Exhibit"A' of Company's IDA): Acres <br />6) SITE FACILITY INFORMATION (If available include any site plan or sketch of the subied facility with this form): <br />❑ New Construction <br />Describe ProiecC <br />❑ New Tenant Requesting Additional Water and/or Sanitary Sewer Allocation <br />(Specify reason(s) for additional allocation request: <br />Full-time Regular i Full-time Contract Employees who will occupy this facility. <br />-Current Amount of Water Allocated to Company by existing Water Service Agreement: <br />`Current Amount of Sewer Allocated to Company by existing Sewer Service Agreement: <br />51 WATER SERVICE IS REQUESTED to COMPANY'S SITE FOR THE FOLLOWING PURPOSE(SI: <br />❑ Domestic Uses (i.e. Drinking, Flushing, Etc.) <br />❑ Other (describe): <br />❑ Domestic Uses (i.e. Wastewater from domestic uses) <br />❑ Other (describe): <br />Total Full -Time Employees <br />gallons per month <br />gallons per month <br />• If Applicable <br />
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