QES Management System
Issue Date: 08/12/2015
Single Residential Application
City West Water
Address Locked Bag 350, Sunshine 3020 Phone 1300 299 228
Email camsapplications@citywestwater.com.au
Application to carry out plumbing work for sewerage, drinking water
and recycled water
NOTE: Please allow a minimum of 10(ten) working days for the completion of this application. Insufficient information may cause
delays.
Office Use Only
Property service number::
SPA:
/
Additional info:
Property details
Lot number:
Plan of subdivision:
Suburb:
Is your property on a combined drain?
Yes
Street number:
Street name:
Postcode:
Melways reference:
No
Owner details (all fields mandatory)
Name:
Email:
Applicant details (all fields mandatory)
Applicant’s name:
Company name (if applicable):
Postal address:
Postcode:
Phone:
Mobile:
Email:
Plumber’s details (all fields mandatory)
Below ground plumbing:
Drainer’s name :
Phone number:
Licence number:
Water connection:
Plumber’s name :
Phone number:
Licence number:
City West Water’s metering services contractor is able to undertake the works to connect to City West Water’s water main.
You are under no obligation to engage this contractor. However if you wish to obtain a quotation for these services please contact
Select Solutions on 1800 186 227.
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Description of work being undertaken (mandatory field):
List of works to be carried out (NB: all application fees are non-refundable)
Residential Dwelling incl. Sewer Connection with Dry Tapping (drinking water), 20mm meter & assembly.
$564.00
Note: Dry tapping location must be accessible and clear of obstructions, if not a re-booking fee may apply.
Residential Dwelling incl. Sewer Connection with Dry Tapping (drinking water), 20mm meter & assembly,
$1280.00
Class A Recycled Water Dry Tapping, 20mm meter & assembly (incl. inspection fees )**
Residential Dwelling incl. Sewer Connection with Wet Tapping (drinking water) 20mm
POA
Drain alteration
$82.50
Replace/renew/alter drains only
$82.50
House extension OR renovation
$82.50
Demolishing and rebuilding – (includes replacement of 20mm water meter)
Please advise if current tapping location meets current requirements otherwise other fees will apply
$282.05
20mm water meter including remote device
$472.75
Remote meters will need to be installed when the meter is located behind a fence, gate (locked or unlocked) or within an
area protected by a security system.
Plugging & re-tapping (Wet area & 20mm Only)
POA
Disconnection of sewer (cut and seal)
$82.50
Disconnection of water (plugging at the water main)
$109.25
Return site to Dry Tapping status
$162.80
Assess and design new branch for sewer connection
$70.50
Important notice for recycled water customers
Recycled water plumbing inspections to be carried out at the following stages: 1. Meter to dwelling; 2. Rough in; 3. Commissioning. The
plumber nominated on this application is responsible for contacting City West Water’s contractor, CIS Services, 1800 627 173 or
inspections@cis1.com.au to schedule inspections. One working day’s notice is required.
I acknowledge that I have read and accept the requirements for connecting to recycled water
I acknowledge that the licensed plumber nominated on the application must install a recycled water washing machine stop tap.
By signing this application form I do so as the owner (or authorised by the owner to make this application). I will therefore be
responsible to meet all City West Water’s requirements including ensuring the security of the water meter(s) and will obtain all
appropriate permits prior to any works commencing. I also acknowledge that should/when a meter(s) be/is installed as a result of this
application then appropriate service charges will apply.
By completing this form you are providing personal information to City West Water for the primary purpose of City West Water providing
you with a water or sewerage connection. To read City West Water’s complete privacy statement, please visit citywestwater.com.au.
Signed:
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Date:
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Checklist
I have attached/completed the following so as to ensure no delays in processing my application:
A copy of a final or an approved stamped site plan (see below for site plan requirements)
Preliminary or draft copies are not acceptable.
A clear description of works
ALL plumber details including licence number
ALL owner details
Credit card/cheque payment details
Once completed, please send all documentation to: camsapplications@citywestwater.com.au OR
Locked Bag 350, Sunshine 3020.
Application will only be assessed if the following details are shown on the
proposed plan:

The property address

All title boundaries

Offset from property boundary to all proposed structures including sheds, pools, etc.

Offset from property boundary to dwelling (marked in blue below)

Driveway and pathway details including the offset and the width

All paved areas
Example of site plan required:
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Cheque
Money order
Credit card
Total: $
Credit card details – PLEASE USE BLOCK LETTERS
Title:
Mr
Mrs
Ms
Miss
Other
Cardholder’s Name:
Address:
Card Type:
Postcode:
Visa
Mastercard
Card Number:
Document FOR-61
Expiry date:
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