Water Availability Request Form

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. Please utilize this same form if the parcel already has an installed water service and only a Water Availability Letter is needed.

Contact Information

Name(Required)

First Last

Phone

Email(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

Is this Availability Letter Needed for Permitting?

Yes

Please Add Any Additional Details or Comments Below

Attachments

Max. file size: 128 MB.

Untitled

First Choice

Second Choice

Third Choice