Hydrant Use Permit Application

Hydrant Use Permit Application

DO NOT complete this form to request a hydrant for a community garden. Arrangements for community garden hydrants can be made by calling

Water Distribution at 612-673-5600.

Organization or Company Name*

Please select your organization or company name below. Select "Not on List / New Customer" if your organization is not listed.

Select

New Organization or Company Name*

Please enter the organization or company name to be used for account creation.

Permit Type*

Select

Applicant Name*

Email Address*

Please enter the email address of someone who can respond to billing and administrative questions

Billing address - Street*

Please enter the billing street address for the organization referenced above

Billing addres - City State ZIP*

Please enter the billing City, State, and ZIP for the organization referenced above

Phone Number*

Phone

Hydrant Use Purpose*

Preferred intersection and corner*

Preferred Install Date*

5 business days are needed after the permit is paid to process the application and install the RPZ

Field Contact Name*

Field Contact Number*

Phone

Certification Statement

Certification statement

By submitting this application, I hereby certify I am authorized to make this application; all information provided on this application or in other submittals is true and accurate to the best of my knowledge; authorization from the owner to perform the proposed work has been granted; all work performed as part of any permit will comply with all applicable state and municipal laws and ordinances, and any required contractor license, personal license, or certificate of competency will be obtained prior to any work being performed. I understand that the issuance of a permit does not grant any contractor license, certificate of competency, business license, or other license, and unlicensed persons shall not be hired to perform work that requires a license or certificate of competency.

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