Meter Remove Or Reset Application

Meter Remove or Reset Application

Combined utility charges apply to and run with the property served. Signed authorization from the property owner is required to disconnect or re-establish the water service.

PROPERTY INFORMATION:
Service Address: / Zip:
Meter Remove: / Yes / No / Meter #: / Tap #:
Meter Reset: / Yes / No / Dwelling Type: / Tap #:
CHARGES
Account #______Account Balance $______
Remove/Reset Charge $ ______Amount Paid $______
Cash____ Check____ Money Order____ Visa ______MC ______
Payer______Daytime Telephone______
(If different from account name)
CURRENT PROPERTY OWNER MAIL BILLS TO: _____TENANT _____ OWNER
Name______Name ______
Address______Address______
______
Daytime Telephone______Daytime Telephone______
______
Signature, Owner Signature, Agent
______
Date Title of Agent / Daytime Telephone
ACCEPTED BY
______
Office Representative
SPU Contact ______Daytime Telephone ______
Comments______
______

Revised 10/2014