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Public Utilities

Reclaimed Water Connection Application

PLEASE NOTE: This application is for requesting a connection of reclaimed water in areas or neighborhoods where it is already available. If reclaimed water is not yet available in your neighborhood, then please fill out and return our Citizen-Initiated Petition Form, and assist us in bringing reclaimed water to your area.


*
Required

* Account Number  
Service Address  
City  
Customer's Name  
Owner Information
* Owner's Name

 

Telephone Number  
Owner's Address  
City  
State  
Country  
Zip  

TYPE OF SERVICE REQUESTED
Single Family, Duplex or Triplex
Multi-family
Open Space
Commercial/Industrial Irrigation only
Commercial/Industrial Use - Metered
Request Hose Connection Adaptor In Lockable Meter Box (No Charge)
Yes
No


I, the Applicant, have read and understand the City's Policies and Regulations for Reclaimed water Service and agree to restrict use of reclaimed water for the purpose(s) described in this application. I understand that due to the chemical composition of reclaimed water that it is not suitable for consumption and may not be compatible for irrigation of certain susceptible vegetation, and I agree that the city will not be held liable for damages that may occur to vegetation or equipment or for damages which may occur due to interruption of service as stated in the City's Policies and Regulations or due to uses of reclaimed water for purposes not included in this application, and agree to defend and hold harmless the City from all claims and judgments arising therefrom against the City by any person.

It is understood and agreed that the customer of the described shall be responsible for prompt payment to the City of Clearwater, Florida, for all City utilities furnished by the City to the described premises in accordance with City Code Rules and Regulations. It is further agreed that the City shall have the right to enter the above premises at any time to inspect the reclaimed water piping and fittings, to discontinue City utilities for nonpayment of service charges, for tampering with the service, for cross-connections with another service or water source, or for any other reason that may be detrimental to the City system.