C I T Y o f O R A N G E B E A C H
COMMUNITY DEVELOPMENT DEPARTMENT
4101 ORANGE BEACH BO
ULEVARD ▪ P.O. BOX 2432
ORANGE BEACH, ALABAMA 36561
PHONE: 251.981.2610
SEWER AVAILABILITY
REQUEST FORM
17-11
PROPERTY INFORMATION
Address: ______________________________________________________________________
_____________________________________________________________________________
Parcel Number: _________________________________________
PPIN: _______________
PROPOSED USE
: RESIDENTIAL
Single Family Residence
Subdivision or Multi-Family: Number of Residential Units _______________
: COMMERCIAL
Please describe proposed use: ___________________________________
_____________________________________________________________________________
_____________________________________________________________________________
REQUESTER’S CONTACT INFORMATION
Name: _______________________________________________________________________
Mailing Address: _______________________________________________________________
_____________________________________________________________________________
Phone Number: ________________________
Fax Number: ___________________________
Email Address: ________________________________________________________________
Requester’s Signature: ___________________________________
Date: ________________
FOR OFFICIAL USE ONLY
Sewer Service: Is Available for this Property Is NOT Available for this Property
__________________________________________________________________ Comments: _
_____________________________________________________________________________
Reviewed By: ___________________________________________
Date: ________________
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