CITY OF WINTER GARDEN
Utility Billing
300 W Plant St Winter Garden, FL 34787
407-656-4100 www.cwgdn.com
Temporary Construction Hydrant Meter Sign-Out Agreement
Account #
Company Name
Company Billing Address
Office Contact Person
Field Contact Person
Phone #
Phone #
Fax #
E-Mail
Project location where meter is to be used
Service Deposit = $200.00
Equipment Deposit = $1,300.00
Non-refundable Initiation Fee = $25.00
Total = $1,525.00
Out Customer Initial
Return Customer Initial
Replacement Cost
Meter Stand
$50.00
Hydrant Wrench
$50.00
2” x 4” Brass Nipple
$50.00
Backflow Device
$170.00
2” Water Meter
$780.00
3” x 2” Brass Bushing
$50.00
2” MIP x Hyd Adapter
$150.00
Total
$1,300.00
Checked out by: Meter # Meter Read (out)
I agree to return this meter and all attachments, in good working order, or forfeit the cost of labor and damaged
components. Meter assembly may not be used on other water systems and may not be taken out of Winter Garden Service
area at any time.
Account Representative: Date:
Checked in by: Date: Meter read (return)
Amount of deposit retained for damage/loss $