Tap Fee - Application for Service Form - Widefield Water and Sanitation District

Tap Fee - Application for Service Form

Application of Service

Date of Application (required)

Location Address (required)

Subdivision

Lot Number

Name of Applicant

Developer

Owner

Renter

Contact Person (required)

Phone Number

Cell Phone

Fax

Description of Project

Meter Size Requested

Choose One

Residential

Commercial

If Commercial, describe uses of building

Service

Existing Service

New Service

Have Plans Been Submitted to the District Engineer

Yes

Date Submitted

If Yes, please provide copies of any correspondence for District decisions for actions.

Engineering Firm (If Applicable)

Contact Person

Phone Number

Cell Phone

Fax

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

I agree to use electronic records and signatures

There was a problem saving your submission. Please try again later.

Please wait while your submission is being saved...

Thank you, your submission has been received.