Construction Water Meter Application

2. Please fill out and submit the following form to request a construction water meter.
   
   The applicant is responsible for the loss of or damage to the water meter and associated equipment. Additionally, the applicant is responsible for any damage to Menlo Park Municipal Water infrastructure that may arise due to the misuse of equipment.
   
   Contact Minol at 844-463-6567 to remit deposit and to answer any other billing questions.
   
   
4. Date
   Date
6. First name
7. Last name
9. Address1
11. Address2
13. City
14. State
15. Zip
17. Company name
19. Address1
21. Address2
23. City
24. State
25. Zip
27. Company representative's name
28. Company representative's email
30. Company representative's phone
32. Phone number
33. Email address
35. Billing address
37. City
38. State
39. Zip
41. Location of service (major cross street)
43. Location of proposed hydrant
45. Please select:*

    1. Deposit payment $3,000 ---- Meter, valve assembly, and stand
47. Water meter*

    1. Applicant is responsible for loss or damage to water meters due to misuse of equipment
51. This section is office use only:
    
    Employee name
    Meter number
    Total deposit
    Start date
    Start read
    Return date
    Final read
    
    __ MPPW contractor __ Private contractor
    __ Place meter __ Keep deposit __ Return deposit
Leave This Blank:


53. Submit Submit and Print

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