HYDRANT \ WATER METER RENTAL FORM

Date

Customer Number

Nature of work/use:

Estimated Return Date

Phone Number

Company Name

MONTHLY AVAILABILITY AND USAGE FEES WILL BE BILLED - NOT CHARGED TO

DEPOSIT. DEPOSIT SUBMITTED IS INSURANCE FOR HYDRANT RETURN ONLY.

As an authorized agent of the firm listed below, I agree to pay any and all costs

associated with the use of this meter, administrative billing and usage costs.

Applicant Signature

First Name

Last Name

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Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

METER TO BE USED IN THE BONNEY LAKE WATER SERVICE AREA

Receipt Bar Code

Deposit

Receipt #

Meter #

Meter Type

Initial Reading

Done By

Date

Last Reading

Done By

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Deposit

Receipt #

Meter #

Meter Type

Initial Reading

Done By

Date

Last Reading

Done By

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Deposit

Receipt #

Meter #

Meter Type

Initial Reading

Done By

Date

Last Reading

Done By

Date