Clifton Park Water Authority - CPWA

Application Type*

Residential

Commercial

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Property Information

Name of Property Owner*

Name of property owner required

Property Address*

Property address required

Tax Map ID

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Owner Information

Owner Mailing Address*

Mailing address required

Owner Phone Number*

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Is this a rental property?*

Yes

No

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Owner Email*

Please let us know your email address.

Service Information

Requested Service Size*

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Requested Meter Size*

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Does the project require private fire service?*

Yes

No

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If Yes, what size?

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Is a lawn irrigation system proposed?*

Yes

No

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Is Water Account to be Placed in the Tenant’s Name?*

Yes

No

N/A

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If Yes, please complete the following:

Name of Tenant

Name of property owner required

Tenant Mailing Address

Mailing address required

Tenant Phone Number

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Tenant Email

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The undersigned, being the owner/tenant associated with the property listed above, hereby requests that the Clifton Park Water Authority supply water to the premises at said location and agrees to comply with all regulations of the CPWA, including those listed in the CPWA’s General Terms and Conditions of Service. The undersigned further understands that they are responsible for all charges for water service to this property until notice to discontinue service is given and a final meter reading is obtained.

Today's Date*

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Signature (Please type in full name)*

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Tenant Signature (Please type in full name)

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*

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Application for Metered Water Service