subject_line
Tap Quote Request Form
3210 E Ave H, Temple, TX 76501
phone: 254-298-5611 email:
utilitydispatch@templetx.gov
Requestor's Name
*
Today's Date
*
🛈
+
Requestor's Email Address
*
Requestor's Phone Number
*
Service Street Address (where services is needed)
*
Type of Property
*
Residential (standard single family residence = 1" tap and 3/4" meter)
Commercial
Type of Business
*
Type of
Water
Service(s) - check all that apply
*
Domestic Water
Irrigation (separate meter from domestic)
Fire Suppression Line (commercial only - Contractor installed)
N/A - Sewer Tap Request Only
Wastewater (
Sewer
) Service Tap Needed?
*
Yes
No, already have sewer service
No, have septic system
Water Service (Domestic) - Size of Tap
*
1"
1 1/2"
2"
3"
4" (contractor installed)
6" (contractor installed)
8" (contractor installed)
10" (contractor installed)
12" (contractor installed)
Water Service (Domestic) - Size of Meter
*
3/4"
1"
1 1/2"
2"
3"
4" (contractor installed)
6" (contractor installed)
8" (contractor installed)
10" (contractor installed)
12" (contractor installed)
Irrigation Service - Size of Tap
*
1"
1 1/2"
2"
3"
4"
6"
Irrigation Service - Size of Meter
*
3/4"
1"
1 1/2"
2"
3"
4"
6"
Sewer Service - Size of Tap
*
4"
6"
Size of Fire Suppression Line (in inches)
*
Who will complete/install the
tap
?
*
City
Contractor
Who will complete/install the meter?
(customer side connections to the meter are always the responsibility of the property owner)
*
City
Contractor
Submit attachments here, if any
Notes to City or Special Instructions (i.e. specific physical tap location, depth of tap/meter)
By entering my full name below, I am providing my electronic signature and verifying that the information I have provided on this form is true and correct, and I am authorized to initiate new service for the address listed on this quote request.
*
Date signed
*
+