Documents & Forms

Customer Service

Form
Description
Billing Adjustment Request (PDF)
To be completed and submitted by the customer with their original invoices or receipts for proof of repair of a leak or pool filling for consideration of a billing adjustment.
Municipal Assessment Form (PDF)
To be completed and submitted to request information pertaining to liens and all monies owed for water / sewer or solid waste assessments.
Notarized Statement of Repair (PDF)
To be completed and submitted by the customer if the original repair invoices or receipts are not available for proof of repair or pool filling for consideration of a billing adjustment.
Unexplained High Water Use Adjustment Request Form (PDF)
To be completed and submitted by the customer for an investigation into an unexplained high water usage occurrence.

Engineering & Contract Management

Form
Description
Agent of Record (PDF)
Letter from Owner/Developer granting engineer of record or his agent permission to act on the owner’s behalf.
Availability of Service (PDF)
To be completed by the Owner/Developer or the engineer requesting confirmation of utility services for a given parcel(s) for financial purposes.
Bill of Sale (DOC)
To be submitted by the Owner/Developer to convey utilities constructed in the public right of way to the County.
Commercial Collection License (PDF)
License to collect and dispose of solid waste in unincorporated Pasco County.
Commercial Wastewater Flow Rates/Calculations (PDF)
Guidelines for determining wastewater flow rates.
Dry Line Approval Letter of Understanding for Water (PDF)
To be completed by the Owner/Developer acknowledging proposed construction of the water line will have no connection to existing water lines.
Dry Line Approval Letter of Understanding for Wastewater (PDF)
To be completed by Owner/Developer acknowledging proposed construction of the wastewater line will have no connection to existing wastewater lines.
Engineer of Record’s Cost Estimate (PDF)
Engineer to submit this listing the pipe, etc., and its cost to construct the utilities in the public right of way to be conveyed to the County.
FDEP Construction Water Permit Application (DOC)
To be used by the project engineer to apply for a Florida Department of Environmental Protection permit for construction of water lines, etc., in the public right of way. This application is normally used where phasing of the project is required.
FDEP Permit Application Checklist (DOC)
Outlines the requirements for submitting the FDEP permit package.
FDEP Permit Clearance Checklist (PDF)
Outlines the requirements for submitting the FDEP certification of completion package.
FDEP Reclaimed Water Permit Application (DOC)
Used by the project engineer to apply for a Florida Department of Environmental Protection permit for construction of reclaimed water lines, etc., in the public right of way.
FDEP Wastewater Permit Application
Used by the project engineer to apply for a Florida Department of Environmental Protection permit for construction of wastewater lines, etc., in the public right of way.
FDEP Wastewater Clearance Application (DOC)
This form is used by the engineer of record to certify the completion of the wastewater collection system under the Florida Department of Environmental Protection wastewater permit.
FDEP Water Clearance Application (DOC)
This form is used by the engineer of record to certify the completion of the water construction project under the Florida Department of Environmental Protection water permit.
Hydrant Meter RequestThis form is to accompany customer payments for a Hydrant Meter.
Jumper Meter RequestThis form is to accompany customer payments for a Jumper Meter.
Letter of Credit (PDF)
Sample of a type of maintenance guarantee to warranty utilities for one year.
License-Maintenance Agreement-CDD (DOC)
This agreement is required whenever a developer, HOA or CDD proposes to place landscaping and/or fencing on County Utility property. The agreement requires the Licensee to assume all liability and responsibility including paying all costs for installation and maintenance of the landscaping and/or fencing.
Maintenance Bond (PDF)
Sample of a type of maintenance guarantee to warranty utilities for one year.
Merchant’s Agreement (DOC)
Form of the agreement between multiple owners for usage and maintenance of a private pump station. To be reviewed and approved by PCU prior to recording by the owners.
FDEP Permit Fee Application
Form needs to be signed by the owner/developer and engineer agreeing to Pasco County’s terms and conditions and payment of commitment and permit fees.
Pressure Main Data Test Sheet (PDF)
Form to be used by the engineer or his representative and County inspectors when conducting a pressure test of the water, wastewater or reclaimed water mains.
Service Connection Application-Single Residential/Commercial (PDF)
Form is to be completed by the owner/developer or the engineer of record for a specific proposed project to request utility services, determine meter size and to calculate all appropriate fees and charges. This form is for a single residential or a commercial project.
Service Connection Application-Subdivision without Reclaim (DOC)
Form is to be completed by the owner/developer or the engineer of record for a specific proposed project to request utility services, determine meter size and to calculate all appropriate fees and charges. This form is for a subdivision without reclaim water.
Service Connection Application-Subdivision with Reclaim (DOC)
Form is to be completed by the owner/developer or the engineer of record for a specific proposed project to request utility services, determine meter size and to calculate all appropriate fees and charges. This form is for a subdivision with reclaim water.
Service Connection Application for Taps and Jumper Meters (PDF)Form is for contractor’s use to request taps and jumper meters for a given project which must be preapproved prior to submittal of payment of fees by the Planning and Service Commitment section.
Solid Waste Management Program User Charge System (DOC)
Guidelines for calculating the fee for solid waste.
Utilities Services Agreement for Water Supply, Wastewater Treatment and Reclaimed Water Supply (DOC)
Form to be used as the agreement between Owner/Developer and Pasco County Board of County Commissioners outlining services to be provided and requirements by each party.
Utilities Services Agreement for Water Supply and Wastewater Treatment (DOC)
Form to be used as an agreement between Owner/Developer and Pasco County Board of County Commissioners outlining services to be provided and requirements by each party.
Master Utility Plan Guidelines (PDF)
Outlines the requirements for submitting an overall utility site plan for proposed utilities including existing utilities in the surrounding area of the proposed project.
Utilities Standards for Design and Construction (PDF)
Standard Details