Oakland County WRC Water Connection Application

Service Information

Service Address

City / Village / Township

Lot Number

Subdivision

Sidwell #

Cross Streets

Applicant Information

First Name

Last Name

Email

Phone

Address

City

Zip Code

Contractor / Plumber Information

Plumber Name

Plumber Phone

Contractor Name

Contractor Phone

Service Type

New ConstructionExisting StructureSprinkler Only

Service Use

ResidentialNon-Residential

Line Size

Meter Size

Line Material

HDPECopper

Service Line Type

Service Line InService Line Staked

Service Line Location

Feet from side of house / building foundation

Which Side?

LeftRight

Fire Line

YesNo

Please Note: A 5/8" dia. "detecto" meter must be installed on the fire line.

Corner Lot

YesNo

Please Note: If your lot is a corner lot, the water tap will be made to the water main that does not require crossing the road.

Existing Well

YesNo

Please Read: The EGLE “Plugging Abandoned Wells” Manual.

I have read and understand the Water Service Connection Regulations (DC-304) and agree to abide by them.

I understand that water bills will be mailed to the service address unless otherwise requested.

I know that water billing starts after the reading device is installed. Please call 248-858-1110 for an appointment.

Applicant's Signature

Date