Bulk Water Application - DPW Fill Station

City of Mt. Pleasant

BULK WATER APPLICATION
Application Date*

MonthDayYear
Date
Business Name*
Business Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number*

Area CodePhone Number
Contact Name*

First NameLast Name
Contact Phone Number*

Area CodePhone Number
Contact Email*
example@example.com
Equipment Type(s)*
Water Use Location and Job Description *
Where will you be using the water? What type of work is it?
I, the undersigned applicant, will accept and be responsible for any and all liabilities resulting from any and all equipment and personnel entering the City of Mt. Pleasant's property for purposes covered under this policy application.
Signature

Clear
City requirements for fill station use:
- Annual fee is $100.00. You must reapply each year.
- Payment of the annual fee provides the applicant access to the City's water fill station from the time the payment is confirmed until City staff remove the water meter and winterize the fill station at the end of the season.
- Fill station is located at the Street Department, 1303 N. Franklin Street and is open 24 hours per day, seven days a week.
- Applicant may use the City's fill station only. Access to the building's water supply is not allowed.
- Applicant is responsible for providing their own hose and 2" female quick disconnect.
- There is a lock on the fill station meter. The lock code changes annually. Applicant will be given the lock code once this application has been received and payment confirmed (typically within 24 hours).
PLEASE READ ALL OF THE INSTRUCTIONS BEFORE PROCEEDING!

Payment instructions have changed.

1. To pay online, click the "Pay Now" button below.

2. Select the "One-Time Payment" option even if you already have an account set up (do not login to your account).

3. Bill Type - Select "Other Payments" from the drop down menu

4. Account Number - Type in "BulkWater" and click "Continue"

5. Complete the remaining payment information. After your payment is submitted, you will receive a confirmation number. Write down this number!

6. Come back to this page and enter it in the box below.

After payment has been submitted, you must return to this page, add your confirmation number below, and click the submit button. IF YOU DO NOT DO THIS STEP, WE WILL NOT RECEIVE YOUR APPLICATION AND WILL HAVE NO WAY OF KNOWING YOU APPLIED!

5. Once payment has been made, call Public Works at (989) 779-5401. Once your payment has been confirmed (typically within 24 hours), we will provide you with the meter lock code so that you may obtain water from the fill station.

If you have any questions,

please call Public Works at (989) 779-5401.
Confirmation Number*
Should be Empty:

City of Mt. Pleasant

5. Complete the remaining payment information. After your payment is submitted, you will receive a confirmation number. Write down this number!