Sub-Meter Assistance Program

Well Type

Choose one Domestic Community

Assessor's Parcel Number

First Name

Last Name

Address

Address 2 (Optional)

City

State

Choose one Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Is Northwest Territories Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

Postal Code

Phone

Email

Confirm Email

How would you like to receive your sub-meter?

Choose one Delivered to my property Pick it up in person

I acknowledge that if I qualify for a one-inch meter under this program, I am accepting the meter “as-is” and that SNWA makes no warranties for the meter. I acknowledge that I have authority to sign this application and that SNWA is providing the meter as a courtesy and shall not be responsible for the meter once I take possession. I certify that all information I provided in this application is true and accurate. Should any information be false in this application, I understand and agree that such furnishing of false information shall, at a minimum, constitute cause for denial of my application. I also agree to abide by the terms of the sub-meter assistance program.