Fillable Complete the Bulk User Connection Permit form and (Sussex County Council)

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Complete the Bulk User Connection Permit form and (Sussex County Council)

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BROWSE SUSSEX COUNTY COUNCIL (DE) FORMS

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July 1, 2017
Complete the Bulk User Connection Permit form and return it, along with a
$75.00* check made payable to Sussex County Council, to:
Sussex County Engineering Department
Utility Permits Division, 3
rd
floor
2 The Circle
P.O. Box 589
Georgetown, DE 19947
* $50.00 covers the cost of issuing the permit and installation of a meter and backflow
device. $25.00 covers the first 5,000 gallons of water usage. Usage over 5,000 gallons
will be billed at $4.00 per 1,000 gallons.
Sussex County Water District
BULK USER CONNECTION PERMIT
Date: Permit #: Check #:
Company:
Address:
Office #:
Industrial Airpark
Cell #:
Dewey Beach Water DistrictDistrict:
Jobsite:
Contact Persons:
1.
2.
Phone #:
Phone #:
Type of Use:
Construction site
Street sweeper
Well pointing
Vactor truck
Tank truck
Pile driving
Black topping
Permit #:
State:
Vehicle Tag #:
Tank Volume:
Other
Estimated Gallons to be Used:
Final Meter
Reading:
Initial Meter
Reading:
Total Gallons
Used:
All water purchased must be utilized within the district the water is purchased from.
Other Information:
Well Drillers License #:
Hydrant # to be Used:
Phone: (302) 85-71
)D[ 
sussexcountyde.gov
Administrative Office Building
2 The Circle
PO Box 589
Georgetown, DE 19947
Revised 09/2018
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Completed 18 July 2020

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