Water Availability Request Form

Please note: Due to demand, applications for water service may require 2-4 weeks to process.

A supplemental application for determination of adequate potable water.

Please complete the form below in order to request a Potable Water Availability Purveyor Letter and a summary of applicable deposits and charges required prior to the installation of new water service(s) or construction of a water main extension. In order to receive a building permit, Jefferson County DCD requires applicants to provide proof of adequate water supply. This includes projects that don’t require additional water (ie. roof replacement, patio, storage shed, etc.) as well as new construction that does require additional water (ie. new single-family home, garage with ADU, detached ADU rental, etc). Please be specific regarding what your permit is for in the comment section below as it could help us process your request faster.

Contact Information

Name(Required)

First Last

Phone(Required)

Address(Required)

Street Address City State ZIP Code

Property Information

Parcel Number(Required)

Parcel Address

Street Address City State ZIP Code

Type of Service

Single-Family Residential

Multi-Family Residential

Commercial

Briefly describe scope of project work(Required)

[remodel, ADU, new construction. etc.]

Please Add Any Additional Details or Comments Below

Attachments

Max. file size: 128 MB.