Plumbing Permit

Plumbing Permit

Please complete the following application to the best of your ability. If you have any questions, contact Wade Jordan, Code Enforcement Officer, at wade.jordan@lincolnmaine.org or 207-794-3372.
Applicant Name*

First NameLast Name
Applicant Phone Number*
Please enter a valid phone number.
Applicant Email*
example@example.com
Property Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Map Number
Lot Number
Subdivision Number
Is applicant the property owner?*

YesNo
Property Owner Name*

First NameLast Name
Property Owner Phone Number*
Please enter a valid phone number.
Property Owner Mailing Address (if different than property address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
This application is for*

New plumbingRelocated plumbing
Type of structure to be served*

Single family residenceModular or mobile homeMultiple family dwellingOther
Plumbing to be installed by*

Master plumberOil burner manManufactured housing dealer/mechanicPlumbing utility employeeProperty owner
License Number*
Hookup and piping relocation (maximum of 1 hook-up)

Hook-up: to public sewer by those cases where the connection is not regulated and inspected by the local sanitary districtHook-up: to an existing subsurface wastewater disposal systemPiping relocation: of sanitary lines, drains, and piping without new fixtures
Are you transferring the permit from another person?*

YesNo
Type of Fixture

Hose bib/SillcockFloor DrainUrinalDrinking FountainIndirect WasteWater Treatment SoftenerGrease/Oil SeparatorRoof DrainBidetBathtub (and shower)Shower (separate)SinkWash BasinWater Closet (toilet)Clothes WasherDish WasherGarbage DisposalLaundry TubWater HeaterOther
Number of Hose Bibs/Sillcocks
Number of Floor Drains
Number of Urinals
Number of Drinking Fountains
Number of Indirect Waste
Number of Water Treatment Softeners
Number of Grease/Oil Separators
Number of Roof Drains
Number of Bidets
Number of Bathtubs (and shower)
Number of Showers (separate)
Number of Sinks
Number of Wash Basins
Number of Water Closets (toilet)
Number of Clothes Washers
Number of Dish Washers
Number of Garbage Disposals
Number of Laundry Tubs
Number of Water Heaters
Number of Other Option
Fee Total (minimum $40 unless you are transferring a permit)
Please pay the above fee by mailing a check made out to Town of Lincoln to the Town Office at 29 Main St after the permit is approved. You may also pay in-person with an appointment by bringing cash, check, or credit card to the Town Office.

I certify that the information submitted is correct to the best of my knowledge and understand that any falsification is reason for the Local Plumbing Inspector(s) to deny a permit.
Signature*

Clear
Amanda will contact you with the total amount owed for your permit.
Should be Empty: