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Hardness Advisory Committee
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TEMPORARY HYDRANT WATER PERMIT APPLICATION
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This form has been modified since it was saved. Please review all fields before submitting.
Type of Hydrant Meter Permit Request
*
Please select if the hydrant meter will be used for construction purposes or a temporary potable hydrant connection for a special event (ex. concert, drinking water).
Hydrant Construction Water
Renewal of Existing Hydrant Construction Water Permit
Temporary Potable Hydrant Connection
Company Name
*
Company Phone Number
*
Email Address
*
Billing Address
*
City
*
State
*
Zip Code
*
Physical Address
*
City
*
State
*
Zip Code
*
Purpose of Water Usage (i.e. backfill,dust control etc):
*
Physical location where water will be used:
*
Physical location where water will be drawn (specify hydrant location):
*
Average water usage per month:
*
Time frame needed for the hydrant meter
*
Time frame needed for the hydrant meter Start Date
—
Time frame needed for the hydrant meter End Date
If your project is going to be done in phases, provide us with your project phasing time line.
Once your approved permit has expired you must return the Districts equipment for a final calibration of the meter and backflow device.
Meter contact person
*
Contact Phone Number
*
Email Address
*
Please understanding that by filling out this permit application does not mean that there will be a hydrant meter available right away. Please check yes, that you understand.
*
Yes
Date and time needing to pick device
*
Date and time needing to pick device
Date and time needing to pick device
By submitting this application, I affirm that the facts set forth in it are true and complete
Name:
*
Date
*
Signature upon picking up device
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Email address
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