Meter Installation Inspection Request Form

2. Water Service Information

4. Service Address*

   Address, City, State, Zip

5. Meter Number:*

9. Applicant Information

11. Company Requesting Inspection*

12. Contact Person:*

13. Phone:

15. Mailing Address*

    Address, City, State, Zip

16. Fax

20. Acknowledgement and Signature
    I understand that the water meter setting inspection will take place within five (5) working days prior to having the Certificate of Occupancy (CO) inspection. If the inspection fails, repairs will be made by the City and all cost will be charged to the water service account (per Ordinance 51.04F). All inspections will take place within one (1) working day of request. All information must be filled in.

    I understand that the water meter setting inspection will take place within five (5) working days prior to having the Certificate of Occupancy (CO) inspection. If the inspection fails, repairs will be made by the City and all cost will be charged to the water service account (per Ordinance 51.04F). All inspections will take place within one (1) working day of request. All information must be filled in.

22. Signature of Authorized Agent:*

23. Date*
    Date

Leave This Blank:


24. Submit Submit and Print

* indicates a required field