Fillable ICE CONNECTION INFORMATION SHEET DRAINAGE SERV (Invercargill City Council New Zealand)

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ICE CONNECTION INFORMATION SHEET DRAINAGE SERV (Invercargill City Council New Zealand)

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DRAINAGE SERV
ICE CONNECTION INFORMATION SHEET
Version: 19/03/2019
NOTE: This information must be completed by a qualified Plumber or Drainlayer and returned to Council on completion of
work. The Building Consent/Resource Consent cannot be completed without this detail.
Mains position measured from Road Boundary - N S E W
Type of Main
Length /
Distance
to Main
Invert
Depth at
Main
Size and
Material of
Main
Direction
of Flow of
Main
Comments
Sewer
Stormwater
Water
Gas
Electrical
Cable
Telephone
Cable
House Service Connections measured from Side Property Boundary - N S E W
Type of
Connection
Connection
Material
from Side
Boundary
Notes: Channel, Pumped,
Type etc …
Water
Sewer
Stormwater
Signed by Contractor: ______________________________ Date:____________________
Please return to Invercargill City Council
Date of Inst
allation: __________________
For Office Use:
Date of Sealing Off: __________________
Contractor: _________________________
Building Consent Number: _______________________
Is the Main on Private Property: Yes No
Is this a: New Build Existing Property
Full Address of Property: ______________________________________________________
Address of Connection (if different from above: ___________________________________
A2465879
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ICE CONNECTION INFORMATION SHEET DRAINAGE SERV (Invercargill City Council New Zealand)

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Completed 29 July 2020

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