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2. To request a new meter, complete the information below and submit.
4. Contact Information
6. Company Name:
8. Form completed by:*
9. Phone #:*
11. Job Site Contact Name:*
12. Phone #:*
14. Utility Account Billing Information
16. Name:*
18. Address:*
20. City:*
21. State: *
22. Zip:*
24. Phone #:*
25. Email:*
27. Service Location Information
29. Address:*
30. City*
    -- Select One --WindsorSanta Rosa
32. Additional Service Location(s)
    if applicable:
34. Engineering Permit #:
36. Meter Type:*

    1. Domestic
    2. Irrigation (Recycled)
    3. Irrigation (Potable)
    4. Commercial
38. Comments/Questions:
40. Applicant Acknowledgement
42. By submission of this form, applicant agrees to observe all Town regulations now and hereafter adopted, related to service. Water shall only be used within the Windsor Water District service area. Applicant further agrees to pay bills promptly. Service may be disconnected if an account becomes delinquent.
44. 
    
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45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

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