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2. 

3. 
   

   Available meter sizes:  1-inch  or  3-inch.

   Deposit amount for 1-inch:  $1,000.00
   Deposit amount for 3-inch:  $2,000.00

   Hydrant meters are available for commercial use only.

5. Rental Date and Return Date*
   Rental Date and Return Date Start Date

   —

   Rental Date and Return Date End Date
6. Please note:

   Maximum rental term is 6 MONTHS.

8. Meter Size Request*

   1. 1-Inch ($1000 deposit)
   2. 3-Inch ($2000 deposit)
10. Business Name*
12. Location*

    (Please enter the address of where the meter will be used.)

14. Contact First Name*
15. Contact Last Name*
17. Phone Number*
18. Email Address*
22. Business Mailing Address*

    (This is also where a refund will be sent if the full deposit is not used.)

24. City*
25. State*
26. Zip Code*
28. Federal Tax ID
32. Fire Hydrant Meter Rental Agreement

    I understand that there is a deposit required for the use of the Fire Hydrant meters:
    Deposit amount for a 1” meter - $1,000.00.   
    Deposit amount for a 3” meter - $2,000.00. 
    
    I understand that the maximum rental period is 6 MONTHS.

    I understand that when I am finished using the meter, I must contact the City of Monroe to schedule an appointment to have the meter picked up.  The Water Department will inspect the meter and record a final reading.   
    
    I understand that if there is damage to the meter, the deposit will be used to pay for the repairs. Furthermore, I understand that if the meter is not returned, the City of Monroe will keep the entire deposit and may pursue legal action. (Ord. 1040.04.j)
    
    I understand that I will receive one final bill for the total water usage, plus a flat meter fee based on the size of the meter.   Any damage charges will also be applied to the final bill.  I understand that my deposit will be applied to the final bill, and if the deposit amount exceeds the total of the final bill, a refund check for the difference will be issued approximately 2 weeks after the return date.

34. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 
    1) your application will not be signed in the sense of a traditional paper document,
    2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 
    3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
36. Electronic Signature*
37. Date*
    Date
41. * * * METER AVAILABILITY NOTICE * * *

    After you submit this application, a representative from the City of Monroe Utility Billing Division will contact you to let you know if a hydrant meter is available and to discuss deposit payment options.
    
    Please note that hydrant meters are in high demand during the spring and summer months; therefore, the City of Monroe cannot guarantee the availability of a hydrant meter.

45. OFFICE USE ONLY:
47. Meter Number
48. Beginning Read
49. Ending Read
51. Meter condition when returned:

    Excellent = Full Refund    /    Fair = Partial Refund    /    Not Returned = No Refund

53. Work Order Completed By
Leave This Blank:


55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit

* indicates a required field