Private Water Leak Application

YesNo
- Applicants Details
  
  Property owner to complete all sections
- Water Account Number*
  e.g WP123XXX
- Name*
  
  First NameLast Name
- Address of Property*
  
  Street Address
  
  Street Address Line 2
  
  SuburbTown/City
  
  Post Code
- YesNo
- Postal Address*
  
  Street Address
  
  Street Address Line 2
  
  SuburbTown/City
  
  Post Code
- Phone Number*
  
  Area CodePhone Number
- Email Address*
  example@example.com
- Date leak repaired*
  
  DayMonthYear
  Date
- Number of household occupants*
- Describe any other water use
  Describe any other water uses e.g swimming pool, livestock or irrigation
- Nature of the leak*
  A brief description of the nature of the leak (e.g burst water pipe)
- Actions taken to repair leak*
  Describe the actions taken to repair the leak (e.g repaired myself or plumber).
- Supporting documentation
  
  Please attach a copy of the plumbers invoice if applicable.
  Cancelof
- Conditions of Assessment
  - The excess water use is as a result of a leak from a private water supply pipe and evidence that the leak has been repaired is provided.
  - In the absence of four previous quarterly readings normal water use may be assessed using the mean water use for an equivalent sized household using the invoice usage comparison chart; plus any other identified water use.
  - Any rates remission approved, will only be applied to the districtwide water supply volumetric rates and the Districtwide water supply fixed rates will still apply.
  - Payment of at a minimum normal water rates quarterly charges is required by each invoiced due date while applications are being considered.
  - Council reserve the right to retrospectively reassess any remission where incorrect information has been provided in this application
- Privacy statement
  
  The personal information collected in this application will be collected for the purpose of assessing applications for rates remission in accordance with Kāpiti Coast District Council’s Privacy Policy and the Privacy Act 2020. Information collected will not be used for any other purpose, except as required by law. You have the right to ask for a copy of any personal information we hold about you, and to ask for it to be corrected if you think it is wrong. If you would like to ask for a copy of your information, or to have it corrected, please contact us at kapiti.council@kapiticoast.govt.nz or +64 4 296 4700.
- I/we declare the information provided on this application is true and accurate to the best of my/our knowledge previousI/we consent to Kāpiti Coast District Council collecting and retaining the personal contact details provided in this application and using these details for the purpose of assessment under this policy.
- Should be Empty:

Applicants Details