Request Water Meter - New Construction

2. NEW WATER METER REQUEST FORM

   Please note that before a meter can be installed, the meter box and lid must be in good working condition, free of debris, and fully accessible. The property must also have a functioning shut-off valve installed, and should be prepared to receive water service. Once the meter is installed, water charges will begin immediately regardless of usage. You will be contacted if there is a problem, and any costs to repair the lid or the box will be at your expense.

4. SERVICE ADDRESS*
5. Lot Number*
7. Additional Units?

   If you are requesting meters for multiple units, please enter the lot numbers and addresses here. You do not need to fill out additional forms for each address. Separate each unit by a comma.

9. PROPERTY TYPE*
   -- Select One --RESIDENTIALCOMMERCIAL
11. Business Name*
12. Contact Person*
14. Billing Address*
16. City*
17. State*
18. Zip Code*
20. Email Address*
21. Phone Number*

23. I/We hereby apply for utility services, and abide by all pertinent ordinances and regulations of West Point City (hereinafter called "The City"). I further agree to pay, when due, the established charges for such services. I agree that The City may shut off the water for failure to pay culinary water, sewer, garbage, secondary water and storm drain charges when due. I understand that, in addition to the above, The City may assess late and/or shut off fees for which I will be responsible for paying if I am late or my water gets shut off for nonpayment. If shut off occurs, all arrears for services including all fees shall be paid in full before service is restored via cash, cashier's check or credit card. In the event that action is required to enforce this agreement, I agree to pay all costs including late fees, shut off fees, collection costs, court costs and reasonable attorney's fees. The person signing below is assumed to be the authorized signer and understands and agrees to the responsibilities aforementioned.

25. Signature*

    By typing your name, you agree to the terms above

Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field