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Bristol Water Meter Option Scheme Application Form If you would like to apply to have a meter please complete this form and return to the address given at the end of this form. Alternatively you can complete an application form online at www. bristolwater. co. uk/meterrequest Customer Account No shown on your bill Your title Your first name Your surname Company Name if applicable Address Postcode Daytime Tel* No* inc code ESSENTIAL Mobile Tel No* Email Address of property to be metered if different from above Are you or your company the owner of the property to be metered Yes No If no have you informed the owner that you wish to have a meter fitted If no please do so before applying. Approximate date of construction Type of Property Please tick relevant box below House / Bungalow Pre 1945 Flat / Maisonette 1945 - 1961 Office 1962 - 1982 Domestic and Business 1983 - 1991 Other Non-household please state. Unknown Number of people living in property Please state how many Number of bedrooms at property Would you consider your water usage to be Do you share a water supply with your neighbour Low Medium High Don t know Is there an externally located stop tap controlling water to the property Any other relevent information ie notification of restricted access/inconvenient visit times Declaration I have read the information relating to opting for a meter and understand and accept the terms and conditions of the meter option scheme particularly those concerning meter reading and reversion to unmetered charges. Signature Date Please send this completed form to Meter Options Team Bristol Water plc 1 Clevedon Walk Nailsea Bristol* BS48 1WA. bristolwater. co. uk/meterrequest Customer Account No shown on your bill Your title Your first name Your surname Company Name if applicable Address Postcode Daytime Tel* No* inc code ESSENTIAL Mobile Tel No* Email Address of property to be metered if different from above Are you or your company the owner of the property to be metered Yes No If no have you informed the owner that you wish to have a meter fitted If no please do so before applying. Approximate date of construction Type of Property Please tick relevant box below House / Bungalow Pre 1945 Flat / Maisonette 1945 - 1961 Office 1962 - 1982 Domestic and Business 1983 - 1991 Other Non-household please state. Approximate date of construction Type of Property Please tick relevant box below House / Bungalow Pre 1945 Flat / Maisonette 1945 - 1961 Office 1962 - 1982 Domestic and Business 1983 - 1991 Other Non-household please state. Unknown Number of people living in property Please state how many Number of bedrooms at property Would you consider your water usage to be Do you share a water supply with your neighbour Low Medium High Don t know Is there an externally located stop tap controlling water to the property Any other relevent information ie notification of restricted access/inconvenient visit times Declaration I have read the information relating to opting for a meter and understand and accept the terms and conditions of the meter option scheme particularly those concerning meter reading and reversion to unmetered charges.

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