Last Updated: 12/7/2020
Permit # _______
PID #______________________
2021
APPLICATION TO CONNECT TO CITY WATER SYSTEM
I, the undersigned, wish to make connection to the City of Jordan Water System for the
address at ______________________. I understand that the connection must be made by
a licensed plumber and in a manner as prescribed by the City Code, that I must purchase
and install only a Jordan meter and reader, and that meters are to be installed horizontally
or you need to purchase and install a horn. I agree to all of the conditions contained
therein of the Water Ordinance as applicable.
Approximate date of connection expected to be ______________________________
___________________________________________________________________
Name of Applicant Phone
___________________________________________________________________
Applicant Email Address
____________________________________________________________________
Street Address City State Zip
____________________________________________________________________
Signature of Applicant Date
FEES:
Water Connection Charge per unit $ 3,503.96 per connection
Water Area Capital Charge per unit
Single Family, Townhouse and Duplex Unit $ 1,818.45 per unit/connection
Condominium or Apartment Unit $ 1,818.45 per unit/connection
Commercial Bldg & Institutional Facilities $ 4,042.65 per unit/connection
Commercial Bldg & Institutional Facilities, Multi Unit $ 1,818.45 per unit/connection
Water Meter/Radio Reader Fee $ 365.00
(This is a 5/8” meter, larger meters will be actual city cost plus 15%)
TOTAL CONNECTION FEE: $__________
______________________________________________________________________
Meter Issued By Date
______________________________________________________________________
Connection Inspected By Date
_______________________________________________________________________
Signature of Individual Picking Up Meter Date
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