Hydrant Meter Application

Utility Billing

Contractor Name

Project Name

Location Where Meter Will Be Placed Address/Cross Streets

Date The Meter Is Needed
Hydrant Meters are only available for pickup on Tuesday's and Thursday's between 8am - 11am

Capital Improvement City Project

Yes No

CIP Number

Contact Name

Phone Number

Email Address

Billing Address

Address Line

Address Line 2

City

State

Zip

Please Attach a Copy of Contractor License Picture and Backflow Test Report

Charges

Refundable Deposit for Meter: $1,400.00

Monthly Rental for Meter: $40.00 /month (As Of 1/1/2013)

Monthly Water Usage Charge: $7.82 / 1000 gallons (As Of 1/1/2020)

Charge will be based on the latest Ordinance rate that is in effect the day the hydrant meter is returned.

Hydrant Meter Fee Schedule & Payment Options

Acknowledgements

I acknowledge that I have reviewed the hydrant meter procedures Hydrant Meter Operating Procedures

I acknowledge that I have reviewed the instructions for checking out a hydrant meter Hydrant Meter Rental & Billing Information

I acknowledge that I have reviewed the meter specifications and backflow requirement documentation Hydrant Meter Specifications & Backflow Requirements

Signature By typing in your signature above, you hereby swear and affirm the information you have provided is true and accurate to the best of your knowledge.