Fillable Application for a Disconnection from Water/ Wastewater/ Stormwater/ (Waitomo District Council New Zealand)

Fill Online, Printable, Fillable, Blank Application for a Disconnection from Water/ Wastewater/ Stormwater/ (Waitomo District Council New Zealand) Form

Use Fill to complete blank online WAITOMO DISTRICT COUNCIL NEW ZEALAND pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Application for a Disconnection from Water/ Wastewater/ Stormwater/ (Waitomo District Council New Zealand)

On average this form takes 10 minutes to complete

The Application for a Disconnection from Water/ Wastewater/ Stormwater/ (Waitomo District Council New Zealand) form is 2 pages long and contains:

  • 0 signatures
  • 9 check-boxes
  • 37 other fields

Country of origin: NEW-ZEALAND
File type: PDF

Use our library of forms to quickly fill and sign your Waitomo District Council New Zealand forms online.

BROWSE WAITOMO DISTRICT COUNCIL NEW ZEALAND FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Application for a Disconnection
from Water/ Wastewater/
Stormwater/ Tradewaste
Queen Street, P O Box 404, Te Kuiti 3941, NZ. Telephone 07-878 0800, Fax 07-878 7771, Email enquiries@waitomo.govt.nz, Website www.waitomo.govt.nz
Name:
Address:
Phone Work: Private:
Mobile: Fax:
1. Applicant Details
Name:
Address:
Phone Work: Private:
Mobile: Fax:
2. Owner Details (if different from Applicant)
Street Address:
Valuation Number:
Legal Description: Lot
DP
3. Details of property requiring disconnection of services
Building
Vacant Land
Front Section
Back Section
Corner Section
House
Flat
Property Type:
Industrial
Commercial
Residential
Property Use:
4. Services to be Disconnected
Water Waste Water Storm Water Tradewaste
PAYMENT IS REQUIRED PRIOR TO JOB BEING DONE
Specify the quantity of disconnections required for each service:
337805 : 003/004 : WS3
Queen Street, P O Box 404, Te Kuiti 3941, NZ. Telephone 07-878 0800, Fax 07-878 7771, Email enquiries@waitomo.govt.nz, Website www.waitomo.govt.nz
4. Sketch Plan
Please sketch a plan of the property showing the boundaries, roads, buildings etc.
Signed:
5. Declaration
7. Ofce 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.
Date:
6. General
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.
Date Received:
Total Fee payable:
Rates adjusted for Disconnection:
Date of Processing:
Trade Waste
Trade Waste Number:
Water Usage
Ordinary Extra Ordinary - Water Meter required.
Water Meter Details
Serial Number:
Reading when installed:
Meter Size:
Engineer Comment:
Engineer Signature:
Date:
Application for a Disconnection
from Water/ Wastewater/
Stormwater/ Tradewaste
337805 : 003/004 : WS3
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Application for a Disconnection from Water Wastewater Stormwater (Waitomo District Council New Zealand)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 8 November 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document