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APPLICATION FOR NEW WATER CONNECTION


SARASOTA COUNTY PUBLIC UTILITIES
Sarasota Office: 1001 Sarasota Center Blvd
Customer Service: (941) 861-6767
Venice Office: 4000 S. Tamiami Trail Fax: (941) 861-0603
Return Completed form by Mailing to: P.O. Box 2553
Sarasota, FL 34230-2553

Please read and complete the information below. Indicate exactly how you would like the name on the account. The name MUST be a legal name and must match Social Security Number or identity documentation provided. Should you wish to visit our office to complete the required documentation, please contact Utilities Connections in advance to schedule an appointment. By appointment only, notary service is available at our office for your convenience if necessary.

Please visit AlertSarasotaCounty.com to register or update your contact information in the county’s emergency notification system to receive emergency alerts (i.e., water and sewer service interruptions; boil water advisories; missing person information; severe weather warnings).

Security Deposit Requirements: A security deposit is required to establish a new account with the department; however, the deposit may be waived subject to an identity check and various other requirements. The deposit is not negotiable or transferable between individuals. Deposits are credited on the account after 24 months of a satisfactory payment record along with accrued interest at a rate approved by the Board of County Commissioners. The Department reserves the right to require a new deposit, increase a deposit amount due to an unsatisfactory payment either by the customer or the location history or require a cash deposit in advance

Federal Trade Commission Identity Theft regulations require all utilities to verify a customer’s identity prior to initiating a new utility account. By this application you hereby attest that the social security number provided (or other documentation) is valid. You also attest that you are authorized to enter into credit agreements for the above named individual/company.

If NO, then you must provide up to three forms of identity which may include driver's license, birth certificate, passport, other utility bill. or other approved form of identification. and the security deposit may be billed on the first bill or paid in advance depending on the payment history at the service location.


Do you authorize Sarasota County Public Utilities to perform an Identity Check in order to establish a new utility account?
123-45-6789
Service Address:*
Customer Name*
Mailing Address (if different)
Do you currently or have you had service with our utility in the last 18 months?*
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Today's Date*




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WATER METER LOCATION STAKING SHEET

I. Place an "X' at the corner of your lot at the street for the location of your water service. Please note that your plumbing line must be located at least ten feet (IO") from your septic tank. The meter box will be installed in the County right-of-way or easement.
2. Indicate if possible, any points of reference from the "X" or state a distance (i.e. driveway, mailbox, etc.).
NOTE: This form must be signed by the property owner/authorized agent. The property owner accepts the responsibility for the location of the meter box. Should the meter need to be moved at a later date because the information provided below is incorrect, the owner may be required to pay for time and materials to move the service/meter.
PLUMBING PERMITS - The Sarasota County Building Department requires that a plumbing permit be obtained when an existing building is connecting to central water service. An application for the permit can be obtained at the Building Department.
Homeowner Occupied Homes - The plumber or the owner may pull the plumbing permit.
Rental Units & Commercial - A licensed plumber is required to pull the permit and perform all plumbing work.

Water Meter Location*
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Date*

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MANDATORY WATER SERVICE BACKFLOW PREVENTION QUESTIONNAIRE

Sarasota County Public Utilities (SCPU) has the primary responsibility for protecting the public water supply from possible contamination from a variety of sources. This questionnaire will assist us in determining if your request for a water service, building/plumbing permit, or landscaping project requires a backflow prevention assembly.

Backflow prevention assemblies are required whenever a property has any auxiliary water systems such as an irrigation system or an active well.

The property owner's responsibility starts at the point of delivery from the public potable water system and includes all of the property's' water systems. The owner is required to install, operate, test, and maintain approved backflow prevention assemblies as directed by the utility in accordance with local codes.

SCPU is required to ensure that all residential, commercial, and industrial consumers are In compliance with SCPU's local ordinance and the Florida Administrative Code 62-555.360.

Please complete the following questionnaire:

RESIDENTIAL BUILDINGS (SINGLE FAMILY HOMES):

Does your residence have the following:*
If yes, your property is subject to maintain a backflow preventer at our water meter . You must have a licensed certified backflow contractor install and certify a backflow preventer at our water meter or if your property already has a backflow preventer, have the backflow preventer certified and the report sent to the backflow department.
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Today's Date*
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