Hydrant Meter Request

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Start Service Date *

Hydrant Meter Address *

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City *

State

Zip Code *

Business Name *

Representative Name *

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Last

Mailing Address Line 1 *

Mailing Address Line 2

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City *

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Zip Code *

Phone *

Alternate Phone

Email *

Tax ID Number *

Emergency Contact (in case of water leak) *

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Last

Emergency Phone *

Backflow Device Required – All hydrant meters are required to have a RP backflow preventer at the meter. This device is to be provided by customer and must be tested annually. Water Delivery Service – By signing you agree that you are applying for water delivery service under the terms and conditions as approved by the Arizona Corporation Commission and agree to pay for the water delivery service at the approved rates. The customer hereby personally guarantees unconditionally and irrevocably the prompt payment of any sums now or hereafter owed to Community Water Company of Green Valley. In addition, you agree to maintain your plumbing in compliance with the current edition of the Uniform Plumbing Code for Water System Safety. The customer shall be responsible for maintaining all facilities on the customer’s side of the meter. Water Rates – Your first bill will include the service establishment charge of $25.00, plus taxes. Our rate tariff schedule is available at www.communitywater.com. Rates are based on meter size and the type of service requested. Account Deposits – If your request for service requires a deposit, we will notify you. Deposits are refundable, earn interest and may be required for each account. Customers may qualify for a waiver of deposit if they have had an account with Community Water within the past two years and at least 12 consecutive months of good payment history (no late payments). Additional deposits may be charged if service is shut-off for non- payment or other reasons. Upon closing the account, the deposit will be applied to final bill. A refund check will be issued if there is a credit, and the customer has no other active accounts. In cases where the customer has another active account, the balance will be transferred to that other account. *

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