NEW SERVICE INTAKE FORM
This form is only necessary if there is not an ongoing ABCWUA Work, Order, Availability Statement, or Connection Permit.

Contact:
Address of Property to be Served:

UPC of the property requesting service. If the UPC is unknown, it can be obtained at the following website: https://experience.arcgis.com/experience/9248998e85dd4a24a36bbaa01eaf1779

Provide a brief description of the development.

Provide any other relevant information.

Current Services Information: Indicate if and how the property may or not be receiving service:
Water:

Provide existing account number if applicable

Provide description of other existing water service type, if the list options do not apply.

Sanitary Sewer:

Provide existing account number if applicable

Provide a description of other existing sanitary sewer service, if the listed options do not apply.

Requested Services Information: Indicate what additional services are desired for the property:

Indicate which, if any, domestic water services are desired.

Indicate which, if any, nonpotable water services are desired. Not applicable to single family residences.

Sanitary sewer service is required in conjunction with water service for any new development.

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