2. Date*
   Date

3. Bristol Water & Sewer Dept. Water Permit APPLICATION

5. LOCATION & DETAILS OF THE PROPERTY:
7. Service Location with House #*
8. Lot #
10. Property Owner Name (s):*
11. Owner's Phone #*
13. CBYD #*
14. CBYD START DATE*
    CBYD START DATE
15. Confirmation of Excavation Permit from Engineering is needed*

    1. Yes, I contacted the Public Works Dept.
    2. No, you need to contact the Public Works Dept. and should do so before finalizing this permit application.
17. INFORMATION ABOUT PLUMBER:
19. Plumber's Name*
20. Plumber's Phone #*
22. License No: P-1 or P-7*
23. LICENSE START DATE*
    LICENSE START DATE
24. LICENSE EXP. DATE*
    LICENSE EXP. DATE
25. Scan copy of Plumbers License*
27. Please describe the proposed work to be done:*

29. A water permit can only be issued to a licensed plumber who holds a valid P-1 or P-7 license.  Said license holder must be on job site at all times.

    BY SIGNING THIS FORM, I AM FAMILIAR WITH THE STANDARD SPECIFICATIONS OF THE DEPARTMENT AND AGREE TO FOLLOW THE RULES & REGULATIONS OF THE BRISTOL WATER & SEWER DEPARTMENT.

31. Signature:
32. Date
34. Email*
35. Please allow up to 4 business days for processing. Do not start work until permit has been issued.
39. OFFICE SPACE ONLY
41. Service Type
    -- Select One --CommercialResidentFire
42. Account #
43. Total Amount Due
44. CID
Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit

* indicates a required field