Queen Street, P O Box 404, Te Kuiti 3941, NZ. Telephone 07-878 0800, Fax 07-878 7771, Email firstname.lastname@example.org, Website www.waitomo.govt.nz
4. Sketch Plan
Please sketch a plan of the property showing the boundaries, roads, buildings etc.
7. Ofce Use
I/We hereby agree to pay the Waitomo District Council all fees and charges as are from time to time
requested, and I/We will abide by all the bylaws and regulations of the said Council which affect the
service applied for.
Normally applications will take 30 working days to process. After the fees have been paid this form
is to be passed on to the Service Engineer.
Total Fee payable:
Rates adjusted for Disconnection:
Date of Processing:
Trade Waste Number:
Ordinary Extra Ordinary - Water Meter required.
Water Meter Details
Reading when installed:
Application for a Disconnection
from Water/ Wastewater/