C:\Users\macdonaldt\Desktop\TMIrrigation.doc 01/20/12
HILLSBOROUGH COUNTY PUBLIC UTILITIES
WORKSHEET FOR COMMERCIAL IRRIGATION METER REQUEST
Return this Worksheet with a detailed site plan depicting the irrigation system, the potable water service, and all
proposed modifications to the systems therein. See Notes on back of form.
___ New Project SR#: ___________________ Multi-family ___ Commercial ___ Common Area ___ Industrial
___ Existing Project Account #:____________ Multi-family ___ Commercial ___ Common Area ___ Industrial
Name on Account/ Project Name: Service Request #: (if new development)
Project Location: Folio Number:
Billing Account Name: Type of Business or Facility:
MailingAddress: TIN/EFIN:
Contact Person:
Daytime Phone #:
Street Address of Meter or Service (see notes):
Pressure Requirement: _________ psi
Total Area of Property: ______ Acres __________ SF
Water Requirement:
Net Irrigable Area: ______ Acres __________ SF
(See note 1)
Average Daily Use: ___________ GPD
Peak Use: ________ GPD ________GPM
Anticipated Meter/Service Size: _______ Inch
(See note 3 for Irrigation requirements)
Hours per Day: ______ Hours
Current source of water for irrigation : _____________________ From ____ am/pm to ____ am/pm
Potable (drinking) water wells on site: ____ yes ____ no Days per Week:____; Weeks per Year:___
If yes, please indicate on attached irrigation plan.
GPD = Gallons per Day
GPM = Gallons per Minute
Comments:
________________________________________________
(Print – Authorized Representative/Title)
_________________________________________________
(Address)
_________________________________________________
(City / State / Zip) (Phone)
Return completed form to:
WaterDept@HillsboroughCounty.Org
NW Service Availability Team
Hillsborough County Water Dept.
15610 Premiere Dr.
Tampa, Florida 33624
____________________________________________________ ______________________________
(Signature) (Date)
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