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<br />Y:\Public Services New \Webpage \SERVICE INSTALLATIONS \Water Service Installation Request Application 2019.docx
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<br />WATER SERVICE REQUEST APPLICATION
<br />Upon application for installation of one or more fire hydrants the customer shall pay such charges as shall be
<br />determined on the basis of actual costs incurred by the District in performing the work as shown in Section 37.01 .
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<br />Where a new water lateral is required, a customized, written estimate of the District's costs will be prepared. The
<br />customer shall deposit the estimated costs with the District prior to commencement of the work as shown in Section
<br />28.02.
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<br />OWNER INFORMATION
<br />Parcel Owner Name:
<br />Contact Name: Contact E -M ail Address :
<br />C ompany Address :
<br />City: State: ZIP Code:
<br />Phone: Fax: Cellular:
<br />*Who is financially responsible for payment of the monthly water bill?
<br />(check one) OWNER APPLICANT
<br />APPLICANT INFORMATION
<br />Company Name:
<br />Contact Name: Contact E -M ail Address :
<br />Company Address:
<br />City: State: ZIP Code:
<br />Phone: Fax: Cellular:
<br />PROJECT INFORMATION
<br />Project Name: Assessor Parcel Number (APN):
<br />Project Address:
<br />City: State: ZIP Code:
<br />Description of Service Installation Required:
<br />Signature of A pplicant : Date :
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<br />Otay Water District, Public Services Division
<br />2554 Sweetwater Springs Blvd
<br />Spring Valley, CA 91978 -2004
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