Home
Careers and RFPs
Calendar
Agendas & Minutes
FAQs
Contact

Start or Stop Service
Jobs
Contact
Rebates

Customer Care
Forms
Conservation
Education
About
I am a…

SNEW: South Norwalk Electric and Water > Forms > Application for New or Modified Water Service

Application for New or Modified Water Service

Font Size:
Share & Bookmark
Feedback
Print

Printable Form, New or Modified Water Service Application Form (PDF)

Related Documents

Standard Meter Pit Configuration Form (PDF)
Tap Permit Application Form (PDF)

Please fill out the application completely. The tap permit must be signed by the owner of record and notarized. Both forms must be returned along with a plot plan before any calculations will be performed.

Date:*
MM slash DD slash YYYY
Property Owner's Name Currently Recorded with Town Clerk*
First Middle Last
Location*
Street Address Tax Lot No.; Block; and District required City State ZIP Code
Applicant's Name (Same if Owner)*
First Middle Last
Applicant's Address*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Business Phone*
Service
Application is For*
- New Service
- Modification of Existing
- Renewal of Existing
Type of Service*
- Single Family¹
- Two Family Structure¹
- Multiple Family²
- Business - Commerical²
- Office²
- Manufacturing²
- Heavy Industrial²
Notes:
1) A-2 certified Plot plan MUST accompany applications.
2) A-2 ceritified Plot and detailed site and utility plans MUST accompany applications.
Architect, Engineer, Designer
Name of Architect, engineer, Designer (if applicable)
First Middle Last
Address of Architect, engineer, Designer (if applicable)
Street Address Address Line 2 City State ZIP Code
Phone of Architect, engineer, Designer (if applicable)
Choice Service
Type of Service Required*
- Domestic Only (including Process Water)
- Fire Only
- Fire and Domestic Separate
- Fire and Domestic Combined
FIRE SERVICES
GPM required
psi residual
Type:
- Wet
- Dry
- Antifreeze
- Foam
Yard Hydrants No.:
Yard Hydrants Type:
Other:
Fixtures
Toilets Flush Valve No.
Toilets Flush Valve Inlet Size
Toilets Tank Type No.
Toilets Tank Type Inlet Size
Shower Stalls No.
Shower Stalls Inlet Size
Bath Tubs No.
Bath Tubs Inlet Size
Shower/Bath comb No.
Shower/Bath comb Inlet Size
Lav Sinks No.
Lav Sinks Inlet Size
Kitchen Sinks No.
Kitchen Sinks Inlet Size
Clothes Washers No.
Clothes Washers Inlet Size
Dishwashers No.
Dishwashers Inlet Size
Hose Connections No.
Hose Connections Inlet Size
City Sewer
- Yes
- No
Basement
- Yes
- No
Existing Well
- Yes
- No
Boiler Corrosion Inhibitor
- Yes
- No
Bldg. Set Back _ feet from prop. Line.
Comments, Explanations and Other Fixtures (Process, Cooling, Inground pool, Lawn Sprinklers, Etc.)

Application for Commercial Electric Service
Application for New or Modified Electric Service
Application for New or Modified Water Service
Application for Residential Electric Service
Customer Authorization Form, Electric Operations
Customer Authorization Form, Water Operations
Request to Disconnect Service
Blanket Deposit Application
Utility Asset Information Request Form
Application for Electric Submetering
Application for Water Submetering

Accessibility Notice
Privacy Policy
Terms of Use

Phone: (203) 866-3366 | 1 State Street; Norwalk, CT 06854
Copyright 2017, South Norwalk Electric and Water; All Rights Reserved :: A Powerful Creation

Customer Care
Forms
Conservation
Education
About
I am a…

Home
Careers and RFPs
Calendar
Agendas & Minutes
FAQs
Contact