Office Use Only:
Acct#: 	 Date of Svc Acct: 		 Application approved
Denied Reason

ID Verified

ST. LUCIE WEST SERVICES DISTRICT (SLWSD)
Temporary Water Meter-Application for Utility Services

Applicant is required to provide the following documentation with application:
Personal identification (ID) of applicant (if for business see details below)
Deposit $1,000.00 for a 2” meter size (request for another meter size will be reviewed by management)

Complete the following information to open an account. (PLEASE PRINT) Hydrant location for temporary water meter:
(Street Address)

Nearest cross street to Hydrant location: 	 Applicant’s name (Primary account holder who is responsible for the service location)

(The security deposit placed on this account will be credited only to the above applicant and is non-transferable)
Mailing address (if different than service address)
																														
City	State	Zip

Main phone # 	Alternate Contact phone # (if applicable) 	

Receive E-Bills  Yes  No

Alternate contact name (Person authorized to be contacted by or to contact SLWSD and to pay bills on the account, if applicable)

What is the temporary meter for?

Construction

Irrigation

Pressure Cleaning

If other, please indicate 	

Important attachment needed on temporary meter - check one:

4 Prong Spicket or

2 Inch Output

Request change in size: Yes	No	(If yes, request will be reviewed by Management for approval)

Water usage: $3.64 per 1,000 gallons plus base rate according to the meter size issued Business Enter Tax ID# 	
**Important: Hydrant connections may need a 2 inch meter according to project.

Connections will be attached according to meter size. Check One:

assembled with no lock

assembled with lock

Applicant is responsible for leaving the temporary water meter assembly in the assigned location. Applicant may request that the SLWSD relocate a specific temporary water meter to another location within the boundaries of the development for which service was originally approved.
Applicant is responsible for any and all damage to private property that may result from utilizing the temporary water meter and backflow assembly. Applicant is responsible for any property damage to the SLWSD water distribution system, including but not limited to damage to the meter and backflow assembly, due to use of the meter and backflow assembly, theft, or vandalism. The Applicant shall be invoiced for the cost of repair or replacement.
Applicant shall not be responsible for normal wear and tear caused by normal use and complying with the Rules of the SLWSD, including but not limited to paying all fees associated with the use of the temporary water meter.
Applicant shall be responsible for their own attachment to the temporary meter.

SLWSD staff will install required meter assembly and backflow prevention to Fire Hydrant (or other source upon request and approval by management).

Applicant Signature:		 Date: 	

450 S.W. Utility Drive ● Port St Lucie, FL 34986 ● Office (772) 340-0220 ● Fax (772) 871-5771 ● customerservice@slwsd.org