Coupeville, WA · Island County
Meter Assembly Use Permit
This permit form is for applicants requesting to use a Town of Coupeville fire hydrant and meter assembly to withdraw water.
What this form is
Applicants use this form to request a fire hydrant and meter assembly for withdrawing water from the Town’s system. It asks for company, billing address, contact, construction location, and applicant signature, and includes a liability release and conditions for use. The form lists a $250 deposit, weekly charge plus usage, and other charges; its conditions limit use to two consecutive seven-day periods.
Who needs it
A company or other applicant seeking to withdraw water from a Town of Coupeville fire hydrant using the Town’s meter assembly needs this permit.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; the applicant signs and dates the permit, and no notarized or sworn attachment is mentioned.
How to submit this form
- 1
Download the Permit
Download the Meter Assembly Use Permit PDF.
- 2
Complete the Form
Enter the company, billing address, contact, phone, and construction location, then sign and date the applicant section.
- 3
Review the Conditions
Read the liability release and general conditions for fire hydrant and meter assembly use.
- 4
Submit to the Town
Submit the completed form to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What is the Meter Assembly Use Permit for?
- It is used to request a Town of Coupeville fire hydrant and meter assembly for withdrawing water from the Town’s system. The form includes applicant details, a liability release, and use conditions.
- Who needs to complete this permit?
- A company or other applicant seeking to withdraw water from a fire hydrant using the Town’s meter assembly should complete the permit form.
- Do I need a notary for the Meter Assembly Use Permit?
- No. The document has an applicant signature and date line but no notary block; the signer just signs and dates it.
- How do I submit the Meter Assembly Use Permit?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Meter Assembly Use Permit doesn’t need a notary — but if you have another Coupeville form that does, a commissioned online notary can help.