Engineering: Utility Availability Request Form

2. Engineering Division
   For additional information please contact the Engineering Division by phone at 407-703-1718.
4. Date Requested*
   Date Requested
6. Property Location

   1. City of Apopka

   1. Orange County

   Please check
8. Name*
9. Email Address*
11. Address
13. City
14. State
15. Zip Code
17. Phone Number
19. Parcel ID*
    Please visit the Orange County Property Appraiser's website at https://www.ocpafl.org for Parcel ID.
21. Existing Conditions
23. Attachment 1
    Please include any attachments for this parcel. Example: Map of parcel or exhibits
24. Attachment 2
    Please include any attachments for this parcel. Example: Map of parcel or exhibits
28. Water Available Location
30. Water Distance (LF) (If Over 50 Feet)
32. Required to tie into water?

    1. Yes
    2. No
34. Sewer Available Location
36. Type of Sewer Line
38. Sewer Distance (LF) (If over 50 feet)
40. Sewer Cost of long service tap (if applicable)
42. Required to tie into sewer?

    1. Yes
    2. No
44. Reclaim Available Location
46. Reclaim Distance (LF) (If over 50 feet)
48. Required to tie into reclaim?

    1. Yes
    2. No
50. Note: Public Services recommend connecting the following:

    1. Into the Water System
    2. Into the Sewer System

    Checked per City Administrator
52. Staff Files Attachment 1
53. Staff Files Attachment 2
55. Comments
Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit

* indicates a required field