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Water & Wastewater Availability Request Form

2. Address*

4. City*

5. State*

6. Zip Code*

8. Property Owner's Name*

9. Property tax I.D. number:*

11. Complete legal description: *

13. Purpose of development (check all that apply):*

    1. Single family
    2. Multi-family

    1. Commercial
    2. Re-development of property
15. If creating new lots, how many: *

17. Please enter any additional comments or relevant information: *

19. Name of person requesting information:*

20. Telephone #:*

22. Email address:*

23. Fax #:

25. Where to send the availability letter?*

27. Please send me a confirmation receipt:*

    1. Yes

29. <b>If you chose to have a confirmation receipt sent to you and do not receive a confirmation receipt please contact the District at (425) 355-3355 to ensure your request is processed.</b>

    If you chose to have a confirmation receipt sent to you and do not receive a confirmation receipt please contact the District at (425) 355-3355 to ensure your request is processed.

Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit Submit and Print

* indicates a required field