THE TORRINGTON WATER COMPANY WATER SERVICE AVAILABILITY INQUIRY AND APPLICATION FOR WATER SERVICE Date: _______________ Address of Property:_________________________________________ If for one single family house describe location – on _________ side of _____________ street between existing houses # ____ and #_______. If for anything other than one single family house provide copy of Assessors map or preliminary site plan. Property Owner’s Name: Mailing Address: Telephone Number: Service to be provided for: ______One single family home ______Condominiums ______Industrial building
______One duplex house ______Commercial building ______Private Fire Service
Signature of owner: ____________________________________ Printed Name: ____________________________________ Date:______________________
FOR OFFICE USE ONLY Does Main Exist at location _______yes size of main ________ _______no – extension required Static Pressure at site: ________ Account Number:_________________ Meter Size: _________________ Service Size: _________________
Private Fire Acct Number:_____________ Backflow Acct Number: _____________
Application Approved by: _____________________ Date: _______________ Company reply of availability or approval of service _________________ Comments: