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Permit ApplicationsPlumbing Permit Application

Job Address*
Street Address City State ZIP Code
Phone
Legal Description
Lot
Block
Addition
Owner*
Owner Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Plumber Name*
Plumber Address*
Street Address Address Line 2 City State ZIP Code
Phone*
License #
Occupancy Group
Zone
WATER TAP - The City shall be entitled to a 24-hour notice before 3/4 inch or 1 inch tap is installed. Notice of larger taps needed shall be given in enough time in advance to enable the City to obtain the necessary materials and equipment.
No:
3/4 inch, 1 inch & above water tap
House Sewer - New - Reconstructed
Water Service - New - Reconstructed
Septic Tank
First Fixture:
Water Closet (toilet)
Bathtub
Lavatory (wash basin)
Shower
Kitchen sink & disposal
Dishwasher
Laundry tray
Clothes washer
Urinal
Drinking fountain
Floor sink or drain
Water heater
Other
Water Connection Fee Applicable
Sewer Connection Fee Applicable
NOTICE: I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be compiled with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. I further acknowledge that all work performed under the application is subject to inspection before final approval is granted.
Date*
Applicant Name*
Applicant's Email*
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