2. To request a new meter, complete the information below and submit. If this is a request for a temporary meter (no engineering permit), please print this form to submit to our office with payment of the applicable deposit and meter set fee. Water shall only be used within the Windsor Water District service area. All hydrant meter request are subject to approval by the Public Works Department.
4. 
   
6. Contact Information
8. Company Name:
10. Form completed by:*
11. Phone #:*
13. Job Site Contact Name:*
14. Phone #:*
16. 
    
18. Utility Account Billing Information
20. Name:*
22. Address:*
24. City:*
25. State: *
26. Zip:*
28. Phone #:*
29. Email:*
31. 
    
33. Service Location Information
35. Address:*
36. City*
    -- Select One --WindsorSanta Rosa
38. Additional Service Location(s)
    if applicable:
40. Type of meter being requested
42. Meter Use:*

    1. Permanent (enter permit # below)
    2. Temporary ($125/per meter set fee)
44. Engineering Permit #:
46. 
    
48. Meter Type:*

    1. Domestic
    2. Irrigation (Recycled)
    3. Irrigation (Potable)
    4. Commercial (indicate type below):
    5. Hydrant ($1,200 deposit)
    6. Bridge ($600 deposit)
    7. Temporary Construction ($200 deposit)
50. 
    
51. 
    
53. Comments/Questions:
55. 
    
57. Applicant Acknowledgement
59. By submission of this form, applicant agrees to observe all Town regulations now and hereafter adopted, related to service. Water shall only be used within the Windsor Water District service area. Applicant further agrees to pay bills promptly. Service may be disconnected if an account becomes delinquent.
61. 
    
63. Temporary Meters - Additional Information
65. Fees
67. Failure to return meter = $106 plus payment in full and forfeiture of deposit
    Hydrant Meter setting = $125 per hour
    Cost to repair a damaged meter will be billed to account owner and will include cost of time and materials.
69. Closing Bill and Deposit
71. Following notification, Town staff will pull the meter and generate a closing statement.
    The deposit on account will apply to the account balance and any fees owing.
    Any remaining credit balance will be sent to the account's mailing address.
73. 
    
Leave This Blank:


75. 1. Receive an email copy of this form.
76. Email address

    This field is not part of the form submission.

77. Submit Submit and Print

* indicates a required field