PART B (please circle) Domestic WATER SUPPLY APPLICATION FORM Non-domestic Mixed Building Water Supply Firemain Connection Sprinkler Address of Premises (for which supply is required) (Block letters) ………………………….……………………………………………………… ………………………………………………………………………………………………………………………………………..……………………………………………. Address for Correspondence (Block letters) ….……………………………………………………………………………………………………………… …………………………………………………………………….…………………………………………………………………………..……………………………………. Description ……………………………………………………………………………………………………………. Number of Dwelling Units …………………………. (State whether retail outlet, office, factory, workshop, domestic, hotel etc.) Size of Connection(s) Required (mm) ………………………………..….. Site Numbers …..……………….……………………………………………………… Floor Area of Non-domestic elements of premises ……………………………..……….. M2 PLANNING REF ………………………………………………….. It is ESSENTIAL to provide the planning reference if the connection is being provided as a result of a planning application and approval. Name of Applicant (Block letters) ……………………………….………………………….…………………………………………………..………………………….. Tel. ……………………..…………………… Mobile ……………..…..…………………………. E-mail .…………….……….…...……………………………………………… DETAILS OF FITTINGS TO BE SUPPLIED From Service Pipe: Number of drinking water points …………….………………… Break Tank Capacity (Litres) ………………………………………. Manufacturing or other non-sanitary purposes State the manufacturing process or other purposes For which water is required Storage Cistern Capacity (Litres) ……………………………….. ……………………………………………………………………………………….. 1. Maps Required - Two copies of the following maps shall be submitted with this application: Site location For developments other than a single dwelling – plan and section showing layout of roads, buildings, proposed watermains and other services 2. Payments - The following payments must be made before any connection can be made to the water supply: All development contributions required under planning legislation (for grants of planning pre January 2014) The connection fee - following agreement on the details of the connection and approval of the plumbing works on site, you will be notified by Irish Water of the charge for the required connection(s). This amount must be paid to Irish Water before a connection will be made Infrastructure Charge – for developments that are not subject to a grant of planning pre January 2014, Irish Water may require a charge to cover the cost of infrastructure provision. These amounts must be paid to Irish Water before a connection will be made Signature ……………………………………………………..…………………….. Date …………………………………..……………. Signed and completed application form should be returned to:- Dublin City Council, Environment & Transportation Dept, Block 1, Floor 4, Civic Offices, Dublin 8 OFFICIAL USE ONLY Application for Replacement of single lead supply including boundary Transfer of supply to mains from obsolete common pipe Replacement of lead shared supply Ref No ________________________ Replacement of lead boundary To avail of boundary offer outside of expiry date Replacement of shared supply Dublin City Council Water Services Division ……………………………………………….…………… Date ………………………………………… Form Rev: 02/15a PTO PART B Dublin City Council Working as an agent of Irish Water Water Supply Application Procedure Step 1 Submit completed water supply application form to Dublin City Council, Environment & Transportation Dept, Block 1, Floor 4, Civic Offices, Dublin 8. Further copies of this form are available from the Dublin City Council website www.dublincity.ie In order to prevent unnecessary delays in obtaining a water supply connection, the following is recommended: The application form should be submitted at an early stage of construction Contact is made at this time with the Water Services Division Plumbing Inspectorate. This is necessary to ensure that the proposed installation and its fittings and materials comply with recognised standards and is approved in advance by the Water Services Division. This will help to prevent delays due to unapproved plumbing installations etc. Plumbing Inspectorate John Comey 222 4396, Eamon Dunne 222 4313, Noel McCormack 222 4395, Jack Candon 222 4356, John Riordan 222 4311, 086 3831171 (Northside) 086 3831254 (Northside) 086 3831194 (Southside) 086 3831169 Materials and Fittings For water supply connections of 100mm or greater, contact should also be made with our Mainlaying Section. This is necessary to ensure that the proposed watermain layout and details are in accordance with Dublin City Council requirements and standards: Mainlaying Section: tel. (01) 222 4375 Step 2 Once the internal plumbing of the development has been approved by Dublin City Council - Water Services Division Plumbing Inspectorate, Irish Water will be informed. Step 3 If Planning Permission was granted before January 2014, the applicant must supply a letter to the Water Services Division from the Dublin City Council Planning Department confirming that all necessary development contributions have been paid. Step 4 A Water Connection Agreement with Acceptance Requirements and invoice for the associated connection and infrastructure charges will be issued by Irish Water, once the above procedures have been satisfactorily complied with. Once the Acceptance Requirements have been satisfied and on receipt of payment, Irish Water will request Dublin City Council, Water Services Division to contact you to schedule the connection. For any queries, after payment has been made, please contact: For small connections, i.e. less than 100mm in size Northside: Finglas Depot, tel. (01) 864 3634 Southside: Marrowbone Lane, tel. (01) 222 4209/4210 For water supply connections of 100mm or greater: Mainlaying Section: tel. (01) 222 4375 Form Rev: 02/15a