Fillable Water Meter Application (City of Veneta)

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Water Meter Application (City of Veneta)

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The Water Meter Application (City of Veneta) form is 1 page long and contains:

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  • 3 check-boxes
  • 9 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Veneta

BROWSE CITY OF VENETA (OR) FORMS

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Service Type:
q Residential q Other
Applicants Name: Phone #:
Service Address:
Mailing Address:
City Zip
Assessor's Map:
(based on # of meters & size)
SDC's: (based on # of meters + 4% admin)
Total Due:
Installed By:
Utility Account #: Sequence #:
WATER METER
APPLICATION
PO Box 458 * Veneta, OR 97487 * 541-935-2191 * 541-935-1838 * www.venetaoregon.gov
Subdivision or Tax Lot#:
I hereby apply for the installation of water service to the above listed property. I agree to comply with all City of Veneta regulations governing the operation or use of City
water facilities. I understand that the water meter will be installed at the nearest public R/W to the property where a water main exists and that the water meter is the
property of the City. I agree to not operate, tamper with, alter or disturb the water meter or meter box without the City's permission except for the customer service valve
located on the house-side of the meter.
Meter Size (Circle One):
3/4" 1" 1.5" 2" 3" Other____________
q Commercial
Street/PO Box
Date
Applicant's Signature
Address Port 2:
State
UTILITY BILLING
Old Register:
Reading:
MXU Port 2:
PUBLIC WORKS DEPARTMENT
BUILDING CLERK
Building Permit #:
Sewer Permit #:
q New Install q Replacement q Removal
Approved By:
Long (-123.):
S:\FORMS\Public Works\word - excel\Water Meter Application.xlsx
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Water Meter Application (City of Veneta)

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Completed 17 July 2020

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