PBWR New Meter Service Location Request

PERMIAN BASIN WATER RESOURCES

NEW METER SERVICE LOCATION APPLICATION

Customer Service: 1-888-812-6268 E-mail: PBWR@myUtilityDirect.com

PBWR.myUtilityDirect.com
SERVICE ADDRESS INFORMATION
If this property is for commercial or other non-residential uses, the minimum meter size for commercial properties is 1 inchand shall be approved by Permian Basin Water Resources. Please select the appropriate response below
Block Number:
Lot Number:
County Parcel ID Number
Address

Street Address

Street Address Line 2

CityState

Zip Code
Square Feet
# of Bedrooms
Number of Bathrooms
Meter Size to Install

Other
Date Service is Requested

Future Date
APPLICANT INFORMATION
Applicant Name
Phone
Format: (000) 000-0000.
Bill Attention
Email
example@example.com
Billing Address

Street Address

Street Address Line 2

CityState

Zip Code
METER INSTALLATION FEES
Meter Tap Fees

Cost is per tap for water service and wastewater service.

5/8" and 3/4" meter sizes = $750.00 ea

1" meter size = $950.00 ea

1 1/2" and 2" meter sizes = cost provided at application

Boring Fee (Outside ICFA)

Cost to be provided at time of application and is based on meter size.

Capacity Fee (Outside ICFA)

Cost to be provided at time of application and is based on meter size.
CROSS-CONNECTION CONTROL INFORMATION
Does the Service Address location have an Automatic Irrigation system?
Does the Service Address location have a Fire Suppression system?

This service address requested on this application has:

Rows	No	Yes
Private Operating well or other alternate water supply
Retention area (pond) supplied by potable water supply
Automatic Irrigation System
Other facility with potential for dispenssing of chemical contamination
Thermal Solar energy system
Zoning for agricultural use or livestock (horses) related activity
Commercial Business
Home Business using possible hazardous materials

If you answered “YES”, you are required to INSTALL a Backflow Prevention Device (BFD The BFD must be tested at the time of installation and ANNUALLY thereafter in accordance with Texas Administrative Code 30 TAC §290.47(bIIA If the system is connected to the hose bib at the home, an atmospheric vacuum breaker on the line from the home to the system is acceptable.
CUSTOMER SERVICE INSPECTION
Prior to the home being sold, a Customer Service Inspection by a TCEQ-certified inspector is required. A copy of the CSI Report shall be submitted to Park Water Company in order to transfer service. Further information related to the Customer Service Inspection can be found here.
I certify that the above information is accurate.

Note: The provision of service is subject to the utility's terms of service established in Certificates of Convenience and Necessity and tarrifs as approved by the Public Utility Commission of Texas.
Printed Applicant Name
Date

MonthDayYear
Date
Signature
For Permian Basin Water Resources Use Only
Assigned Route
ICFA Code
Rate Code
Should be Empty:

PERMIAN BASIN WATER RESOURCES