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Certificate of Water Availability
This form has been modified since it was saved. Please review all fields before submitting.
Processing Fee: $200
This Certificate provides information necessary to evaluate development proposals.
Inside City Limits?
Preliminary Plat or PUD
If other, please describe
Applicant's First Name
Applicant's Last Name
Applicant's Phone Number
Applicant's Mailing Address
Property Address / Location
Please attach map and legal description
Water Purveyor Information
1. Choose select one of the options in this section. Please provide additional information as required.
a. Water will be provided by service connection only to an existing (size) water main that is feet from the site.
If yes, what size water main?
If yes, how many feet from the site?
b. Water service will require an improvement to the water system of
Feet of water main to reach the site
The construction of a distribution system on the site
Other (please describe)
If feet of water main to reach the site, how many feet?
If other, please describe
2. Choose yes for one option in this section.
a. The water system is in conformance with a City/County approved water comprehensive Plan.
b. The water system improvement is not in conformance with a County approved water comprehensive plan and will require a water comprehensive plan amendment.
3. Choose yes for one option in this section.
a. The proposed project is within corporate limits of the City or has been granted Boundary Review Board approval for extension of service outside of the City, or is within the County approved service area of a private water purveyor.
b. Annexation or Boundary Review Board (BRB) approval will be necessary to provide service.
4. Choose select one of the options in this section. Please provide additional information as required.
a. Water is/or will be available at the rate of flow and duration indicated below at no less than 20 pounds per square inch.
Rate of flow
Less than 500 gpm
500 to 999 gpm
1000 gpm or more
If rate of flow is less than 500 gpm, list approximate gpm
Flow test of
Less than 1 hour
1 hour to 2 hours
2 hours or more
If duration is other, please describe
Commercial building permits require flow test or calculation
b. Water system is not capable of providing fire flow.
5. Water System has water right certificates or water claims sufficient to provide service.
Comments / Conditions
I hereby certify that the above water purveyor information is true. This certification shall be valid for one year from date of signature.
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