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City of Oldsmar Application for Water/Wastewater Service

2. Date

3. Check one*

   1. Commercial
   2. Residential
   3. Irrigation

4. Meter size*

6. Legal Description

7. Property Address*

9. Owner or Authorized Representative*

10. Mailing Address*

12. Phone

13. Email*

15. 7th Edition (2020) Florida Plumbing Code Applies
    IRRIGATION METERS ONLY: Irrigation meters will be placed next to present meter only. Appointment cannot be made for installation. Homeowner will be responsible for installing systems to meter.

    IRRIGATION METERS ONLY: Irrigation meters will be placed next to present meter only. Appointment cannot be made for installation. Homeowner will be responsible for installing systems to meter.

17. If commercial, complete the following:

19. Name of firm and mailing address:

20. Person responsible for Bill:

22. Email Address:

23. Phone No.

25. Signature

27. Square Foot Bldg

28. This building will be sprinkled:

    1. Yes
    2. No

29. Is there a fire hydrant on this property:

    1. Yes
    2. No

31. Permit No.

32. Permit Fees Due: $

33. Receipt No.

34. Total Amount Rec'd

36. Work Order No.

37. Security Deposit

38. Date:
    Date:

40. Water Impact Fee

41. Sewer Impact Fee

42. Water Connection

43. Sewer Connections

45. Number of ERU's

Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field