City of LaFayette

LaFayette, Georgia

Water tap application

 

Date of application:  Day  _____     Month  _____     Year  _____

Name:  __________________________________     Phone:  _________________

Location of requested water service:  ______________________________________

___________________________________________________________________

Type of service:   Residential  _____                              Other  _____

                           Commercial  _____                            Industrial  _____

 

This is only an application for water service and can only be approved pending investigation by the Water Department personnel.

 

Please note:  All new water services installed on the City of LaFayette water system will have a back flow preventer as part of the installation in accordance with our cross-connection control program; therefore, each customer must have a thermal expansion devise properly installed to protect their hot water heater against thermal expansion.

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Applicant's signature

 

________________________________________________________________________

Do not write below this line

Water Department recommendation:  _________________________________________

______________________________________________________________________

______________________________________________________________________

Checked by _________________                  Water superintendent __________________

Revised August 2004

 

 

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