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C:\Users\dmontour\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\LE55XXHY\Hydrant.doc Form WU0002 (revised 7/2015) PERMIT FOR HYDRANT CONNECTION CITY OF MIDDLETON 7426 Hubbard Ave. Middleton, WI 53562 608/821-8370 608/827-1080 fax Those wishing to draw water from a hydrant shall request a permit from the Utility and agree to pay all fees and abide by all conditions of the permit as outlined herein. Hydrant connections will be limited to single or double ¾ inch hose bib valve. Larger meter hookups will require a tested backflow preventer (not provided by the City) and additional connection fees. Damaged or lost equipment will be repaired at customer's expense. Water will be metered and billed at current rates. Service charge up to 7 days $50.00 Over 7 days add: $13.50 - 5/8” meter (Billed at $2.53/1,000 gal.) $ TOTAL Date paid LOCATION DATE SET DATE REMOVED WATER CONSUMPTION Finish Read Start Read Total MATERIALS USED APPLICANT ADDRESS BILLING ADDRESS (if different) EMAIL SIGNATURE