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2. This form is to be used to determine the availability of city water, sewer, irrigation and reclaimed water services. Allow a seven day response time from the receipt of this request. Please answer all questions to the site location, as incomplete forms may results in delays. All backflow devices to be supplied by the contractor.
4. Requestor
5. Date
   Date
7. Address or Company
9. Phone
10. Fax
12. Requestor Position

    1. Property Owner
    2. Prospective Buyer
    3. Real Estate Agent
    4. Other
13. Availability Status

    1. Water Availability
    2. Water Availability for Irrigation Meter
    3. Reclaimed Water Availability for Irrigation
    4. Sewer Availability
17. Site Location
19. Address
21. Block
22. Lot Number
24. Reported By
25. Date Reported
    Date Reported
27. Water Available to Site

    1. Yes
    2. No
28. Three Quarter Inches Irrigation Available

    1. Yes
    2. No
30. Reclaimed Water Available

    1. Yes
    2. No
31. Sewer Available to Site

    1. Yes
    2. No
33. One Inch Irrigation Available

    1. Yes
    2. No
34. Water Type

    1. County Water
    2. City Water
36. Special Situations
38. Water Location & Sewer Location
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field