Reclaimed Water Service Application

Application Type *

Residential

Vacant Lot

*Commercial (Commercial applicants will be required to submit a worksheet.)

Is this application for a commercial property? *

Yes

No

Acknowledgement for Commercial Applicants *

For Commercial Properties: I acknowledge I will be required to submit a completed Irrigation Area Worksheet with this application. (Link to worksheet will be provided once this application has been submitted.)

Owner's Full Name *

Service Address *

City (or unincorporated) *

Zip Code *

E-mail Address *

Daytime Phone Number *

What is your current irrigation supply? *

N/A

Well

County supplied drinking water

Surface water-lake-pond

What type of connection do you require? *

Irrigation System

Hose Connection

Above Ground Hose Bibb $95.00

I, the Applicant, have read and understand the County's Policies, Procedures and Regulations for Reclaimed Water Service and agree to use reclaimed water for the purpose(s) described therein. I understand the County cannot, at all times, guarantee a supply of reclaimed water, and I agree that the County will not be held liable for damages resulting from an inadequate supply of reclaimed water. I understand due to the chemical composition of reclaimed water, it may not be compatible for irrigation of certain vegetation, and I agree that the County will not be held liable for damages that may occur to vegetation or for damages which may occur due to uses of reclaimed water for purposes not included in the County's Policies, Procedures and Regulations for Reclaimed Water Service. I agree to defend, and hold harmless, the County from all claims and judgments against the County by any person arising from the use of reclaimed water or the operation of the reclaimed water system on my premises.

It is further agreed that the County, or Pinellas County Public Health Unit, shall have the right to enter the above premises to inspect the reclaimed water piping and fittings. I agree the County has the right to discontinue County reclaimed water service: for tampering with the service (includes meter and appurtenances), for cross connections with another service or water source, or for any other reason that may be detrimental to Pinellas County Utilities.

The residential reclaimed water meter installation needs to be paid prior to the acceptance of the application.

Upon transfer of owner or resident, I will inform the new owner or tenants that the property is connected to Reclaimed Water.

Agreement *

Terms of Application Accepted

Owner's Name *

Date * +

Note: Fields marked with an * are required fields.