DEVELOPMENT SERVICES DEPARTMENT
PROJECT FACILITY AVAILABILITY - POTABLE WATER
Please type or use pen
____________________________________________________________
Owner’s Name Phone
____________________________________________________________
Owner’s Mailing Address Street
____________________________________________________________
City State Zip
ORG___________
ACCT__________
ACT___________
TASK__________ AMT $___________
DATE__________
DISTRICT CASHIER’S USE ONLY
SECTION 1. PROJECT DESCRIPTION TO BE COMPLETED BY APPLICANT
A. Major Subdivision (TM) Specific Plan or Specific Plan Amendment
Minor Subdivision (TPM) Certificate of Compliance:_____________
Boundary Adjustment
Rezone (Reclassification) from______________ to ______________ zone.
Development Permit, purpose:___________________________________
Use Permit, purpose:__________________________________________
Time Extension/ Expired Map Case No.____________________________
Other_______________________________________________________
B. Residential . . . . . . Total number of dwelling units_____________________
Commercial. . . . . .Gross floor area________________________________
Industrial . . . . . . . Gross floor area________________________________
Other . . . . . . . . . . Gross floor area________________________________
C. Total Project acreage ______Total number of lots____________________
D. Is the project proposing the use of groundwater? Yes No
Is the project proposing the use of reclaimed water? Yes No
E. Applicant acknowledges that a copy of the Project Facility Availability for Fire
Service is attached.
Assessor’s Parcel Number(s)
(Add extra if necessary)
By signing below, the applicant acknowledges that the information provided is accurate and acknowledges that any significant modification of the
proposed project may result in changes to the District’s draft conditions/availability to serve.
Applicant’s Signature:_____________________________________________________________ Date:______________________________________
Project Address:________________________________________________________________ Phone:_____________________________________
(On completion of above, present to the District that provides water protection to complete Section 2 below.)
SECTION 2: FACILITY AVAILABILITY
TO BE COMPLETED BY WATER DISTRICT
District Name:_______________________________ Service area______________________________ Project Number:_________________________
A. Project is in the district.
Project is not in the district but is within its Sphere of Influence boundary, owner may apply for annexation.
Project is not in the district and is not within its Sphere of Influence boundary.
The project is not located entirely within the district and a potential boundary issue exists with the ______________________________ District.
Project DID DID NOT conduct a due diligence review with the water district.
B. Facilities to serve the project ARE ARE NOT in the vicinity of the property. Explain in space below or on attached________________
_______________________________________________________________________________. (Number of sheets attached __________)
Project will not be served for the following reason(s):________________________________________________________________________
_________________________________________________________________________________________________________________
C. District conditions are attached. Number of sheets attached:_______________
District has specific water reclamation conditions which are attached. Number of sheets attached:_________________
District will submit conditions at a later date.
This Project Facility Availability Form is valid until final discretionary action is taken pursuant to the application for the proposed project or until it is
withdrawn, unless a shorter expiration date is otherwise noted.
Authorized Signature:______________________________________________ Print Name_____________________________________
Print Title_____________________________________________ Phone______________________________________ Date____________________
NOTE: THIS DOCUMENT IS NOT A COMMITMENT OF SERVICE OR FACILITIES BY THE DISTRICT
On completion of Section 2 by the District, applicant is to submit this form with application to:
Development Services Department - 1 Town Square, Murrieta, CA 92562
