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Water Main Application

If you need assistance with this application, please call the New Service Contact Center at (317) 927-4444.

General Information

Utility:
Project Name:		Project Description:

Primary Contact Information

Primary Contact First Name:		Primary Contact Last Name:
Primary Contact Email:		Primary Contact Phone Number: ( ) - Second three digits Last four digits
Permit Address:
City:		State:
ZIP Code:		County:
Township:

Owner/Developer Information

Company Name:
Address:
City:		State:
ZIP Code:
Contact Person First Name:		Contact Person Last Name:
Phone Number: ( ) - Second three digits Last four digits		Email:

Design Firm Information

Design Firm Company Name:
Address:
City:		State:
ZIP Code:
Contact Person First Name:		Contact Person Last Name:
Phone Number: ( ) - Second three digits Last four digits		Email:

Contractor Information

Contractor Company Name: If unknown, please input TBD
Contact Person First Name:		Contact Person Last Name:
Phone Number: ( ) - Second three digits Last four digits		Email:

Water Main Design Summary

Does this project include an offsite main?

Yes
No

If Yes, must be submitted as separate application from the onsite main

Type of Project:

Number of Lots:

Location of Project (relative to streets):

The new water main connection will be connected to an existing water main at

(relative to streets)

Terms and Conditions

I agree to the Terms and Conditions and I have been authorized by the property owner to perform the work described in this application

I agree

By clicking the submit button below, the applicant agrees to comply at all times with the Terms and Conditions for Watermain, Water Standards, and all other applicable rules, regulations, and standards (local, city, state, and federal).

Once your submission is reviewed, a REACH representative will contact you for the next steps with your application including uploading documents including the drawings and hydraulic information form.