WASCO

Account No. for existing meter

Is sewer service required ?

Yes

No

Water Supply Account No.

Name of Applicant:

Gender

Male

Female

Status of Applicant:

Owner

Tenant

Contractor

Other

If 2 - 4, Give Name and Address of Owner:

Postal Address:

E-mail:

Telephone Number:

Is this residence part of a development?

Yes

No

If Yes, name of Developer or original and owner:

Area:

Directions to Property:

Nearest Lucelec Meter Number:

Nearest Water Meter Tag/Serial Number:

Type of House:

Wooden

Wall

Other

Colour of House:

House Location:

Right

Left

BPN#:

Has approval been obtained from development control authority

Yes

No

If yes, Date of Approval:

Plan Number:

Water & Sewerage Company INC Application for Service Connection