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SEWER SERVICE REQUEST APPLICATION
Total Number of EDU’s for this construction: , as shown in Section 53.08.
Commercial User Classification for this construction: , as shown in Section 53.11.C.
A Sewer Capacity Fee is applied to your quote as shown in Section 53.03.A (1) and 53.03.A (2).
Agreement to Notify District of Completed Sewer Connection is required.
OWNER INFORMATION
Parcel Owner Name:
Contact Name: Contact E-Mail Address:
Company Address:
City: State: ZIP Code:
Phone: Fax: Cellular:
*Who is financially responsible for payment of the monthly water bill?
(check one) OWNER APPLICANT
APPLICANT INFORMATION
Company Name:
Contact Name: Contact E-Mail Address:
Company Address:
City: State: ZIP Code:
Phone: Fax: Cellular:
PROJECT INFORMATION
Project Name: Assessor Parcel Number (APN):
Project Address:
City: State: ZIP Code:
Description of Service Installation Required:
Signature of Applicant: Date:
Otay Water District, Public Services Division 2554 Sweetwater Springs Blvd Spring Valley, CA 91978-2004