HomeMy WebLinkAboutWaterTapApplication_fillableWater Tap
Application
Internal Use Only
Date Received: _________________
Date Approved: _________________
Date Tap Scheduled: _____________
S:\Forms\App_Taps_TEMPLATE.docx Rev. 12/16
Only one (1) tap per application.
Job Site Information
Legal Description:
Address:
City: State: ZIP Code:
General Contractor Information
Name: Phone:
Mailing address:
City: State: ZIP Code:
Certified Sewer & Water Installer Information
Name: Phone:
Mailing address:
City: State: ZIP Code:
E-mail address:
Building Permit Information
Building Permit Number: N/A
Excavation Permit or Project Information
Excavation Permit or Project Number: N/A
LUST Area
Yes No
Sketch of Construction Plan (May attach a drawing instead) Tap Information
(NOTE: Annotate the number of water meters to be installed on each individual line, as appropriate)
Type of tap:
(check all that apply)
Single Family
Business
Multi-Family - # of Units:
___________________
Other – Please Specify:
___________________
Cost of taps
(circle one)
1” to 2” $90.00
4” $440.00
6” $480.00
8” $510.00
10” $560.00
12” $610.00
Payment Received :
(housing official initial)
Signature of applicant: Date:
Signature of Development Services official: Date:
INFORMATION FOR WATER TAP APPLICATION AND INSTALLATION
1. All requested information is required. Incomplete applications will be returned.
Unsigned applications will not be approved.
2. Water tap applications are reviewed in order received within one (1) business day.
3. A sketched plan is required in the space provided or as an attachment. Plans must be
legible and include notes on all materials and sizes being used.
4. Any unapproved changes to the approved application may result in delay to requested
water services.
5. Water service entry into a building must be staked near the foundation before the tap
will be made. The approved application and stake locations must match.
6. Taps will not be completed until all existing inactive services are properly abandoned.
Water Division staff must be on site to verify all abandonments.
7. Water service taps will not be made until a building foundation is in place.
8. The Department of Natural Resources (IDNR) tracks leaking underground storage tanks
(LUST) for the state. For identifying LUST sites and areas, visit www.iowadnr.gov.
9. Current water standards, specifications, and policies may be found on the Iowa City
website at www.icgov.org/waterresources.
10. For any questions about the approval of tap applications, contact the Water Division
Water Engineer, 319-356-5056.
11. To schedule a tap, please contact the Water Division Front Desk, 319-356-5160. Taps
will not be scheduled until the tap application has been approved.