Form Builder

Required fields are marked with asterisks (*)

Water Main Tie-in Permit Application Form Criteria

**Note: This application is required for all water main tie-ins that require modification or shut down to the adjacent water distribution system.

Applicant name:

Business address:

Phone

**This application must be made a minimum of 10 business days prior to water main tie-in work taking place. This allows for preparatory work in advance of modifications to the water distribution system and to provide ample time for notification of affected customers.

Planned tie-in work date

Duration of distribution water main shut down

Description of distribution water main work

Attach Issued for Construction Drawing (please highlight proposed tie-in location on drawing). Maximum file upload size is 20MB

Browse…

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Attach issued for construction drawing (please highlight proposed tie-in location on drawing) Maximum file upload size is 20MB

Browse…

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Have the water main pressure test and chlorination results passed?

Yes

Location of area affected, list block number and street name

Expected number of addresses affected

**Note: Please allow City staff to review and respond within 96 hours following the submission of your Water Main Tie-in Permit Application.

Collection of information
Personal information is collected by the City of Port Moody pursuant to Section 26 of the British Columbia Freedom of Information and Protection of Privacy Act, R.S.B.C. 1996, c. 165. Questions regarding this collection of information can be directed to the City’s Legislative Services department by email at FOI@portmoody.ca or mail at 100 Newport Drive, Port Moody, B.C. V3H 5C9.