Report (2) Water Meter Fixture Unit Worksheet for Additions/Remodels/ADUs
Please complete the following information:
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Customer Name: c 0 t 1 C 0 ifde" 1e.^ ` t.
r 1 . ,, ai 0—.101 144 L L L
Service Address: Street/Suite#: 93 sa., ° t,J c? €4^ i r. .G -.. ,_ t .
City: `r"% State: f7 Y2, Zip;....,
Phone Number: (,,"303.) L ._ 17 Email: a"C t ." 5 ,. 1- IttaW~- , .c
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Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add.
Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at
total, the proposed total.
Fixture Unit Current Point Current Proposed Point Proposed
Quantity Value Total Addition Value Total
Bar sink x 1 = x 1 =
Bidet x 1 = x 1
Clothes washer I x 4 = t-1 x 4 =
Dishwasher ( x 1.5 = m F S. x 1.5 =
1"Outside Water Spigot 1 x 2.5 = t.5 x 2.5 =
Water Spigot,each add'l 1 x 1 = ( x 1 =
Kitchen sink d x 1.5 = 1 ,,5 x 1.5 =
Laundry sink x 1.5 = x 1.5 =
Lavatory(bathroom sink) 1 x 1 = 1 1 x 1 =
Water closet,1.6 GPF(toilet) 1 x 2.5 = , , 5 1 x 2.5 = ,'!,,
Bathtub/whirlpool x 4 = 1 x 4
Shower stall i * x 2 = x 2 = ,
_ ..._ ....Bath/shower combo x 4 = x 4 =
Current Points: l 1 Proposed Increase: , S
Current Points+Proposed Increase= ' .•15 =New Total Points =Required Meter Size
Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points=3/4" 37.5 and over points= 1"
New Meter Size Needed for New Total Points: _ m Cost: $ m__m,.,_,....... (see page 1)
Current Meter Size per Utility Billing: Cost: $, (see page 1)
New Meter Size Cost minus Current Meter Size Cost= $
(This is Your Cost to Increase Meter Size Due to Additional Fixture Units)
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FOR OFFICE USE ONLY No Meter Upsize Will Be Required Per UB
J Bentley 01/18/2022
Current Meter Size Confirmed with UB
Signature of UB Representative Date
_ . .,. Page
h/Building/Forms/WaterMeters_070121 Add.dOCX