INDIAN HILLS WATER DISTRICT WATER LICENSE (TAP) APPLICATION
Owners Name(s): _______________________________________________________
Current Mailing Address: ___________________________________________________
E-Mail: Best time to call:
This application must be for a property within the Indian Hills Water District. In order for this application to be accepted, a copy of the most recent Jefferson County tax statement must be attached and list the IHWD in the Tax Authority column.
Street address where water tap will be located: _____________________________________
Copy of County Property Tax Statement attached? Yes No
Is there an existing building on the property? Yes No
What is the building used for? Residence Business Other:___________________
How many people reside (or will reside) at this property? ___________
Is there an operating well on the property? Yes No
If there is an existing well has it been tested for: Production? Quality?
A deposit of $100 is required.
Please sign below indicating all information on this application is correct and that, if approved, use under the license for the tap must be as limited and defined by the Rules and Regulations of the Indian Hills Water District. (a copy of the rules and regulations are available on this web site)