Water & Sewer Tapping Permit Application

Water & Sewer Tapping Permit Application

Select the permit type and enter the permit holder and tap details, then sign and submit.
Permit Holder Information
Permit Issued To
Permit Location

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Billing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Select Which Permit You Are Applying For
Water Tapping Permit
Water Tap Type
Tap Size
Meter Size
Sewer Tapping Permit

The cost is $1000.00 For Any Size
Tap Size Needed
Applicant Signature
Applicant Signature
Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Superintendent Approval
Approved and ready for Clerk-Treasurer approval?
Signature
Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Clerk-Treasurer Approval
Approved and ready for payment?
Signature
Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Deputy Clerk Approval
Amount Received
Enter the total amount received (e.g. $2,000.00)
Payment Method
Check #
If paid by check
Have all payments been received?
Signature
Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Permit Holder Information