Application For Extension of or Connection to Municipal Water and/or Sanitary Sewer Works

To find out more information, please contact the following: Engineering & Development Services Department City Hall 169 Front Street, Belleville, ON K8N 2Y8 Telephone: 613-967-3200 X3542 Email: construction@belleville.ca

Applicant Information:

Name:

Property Address:

Mailing Address:

Home Number:

Work/Cell Number:

E-mail:

Nature of Application:

Service being requested:

Water

Sanitary Sewer

*Under City of Belleville Connection Charge By-Law 2019-183, connection to both municipal water and sewer are required where both exist.

Additional Comments or Questions:

Applicant Signature:

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For Internal Use Only

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Application For Extension of or Connection to Municipal Water and/or Sanitary Sewer Works

Applicant Information:

Nature of Application:

For Internal Use Only

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