Lake Havasu City, AZ · Mohave County
Irrigation Meter Advisory & Acknowledgement
This acknowledgement records an owner’s agreement to follow irrigation meter and backflow requirements before Lake Havasu City issues a backflow prevention permit.
What this form is
The property owner signs this acknowledgement to confirm receipt of the irrigation meter advisory and agreement to its provisions. The City must receive it before issuing the backflow prevention permit and installing the irrigation meter. It explains backflow device installation and testing responsibilities, related costs, and water rates, and asks for the property address, owner’s printed name, signature, and date.
Who needs it
A property owner seeking an irrigation meter must sign this acknowledgement before the City issues the backflow prevention permit and installs the meter.
How to submit it
The acknowledgement must be received by the City before the backflow prevention permit is issued and the irrigation meter is installed. The form lists the Development Services Department, Building Division, at 2330 McCulloch Boulevard North, Lake Havasu City, AZ 86403, and [email protected].
About notarization
This document is signed without a notary; the owner signs and dates the acknowledgement, with no notarized or sworn attachment described.
How to submit this form
- 1
Download The PDF
Download the Irrigation Meter Advisory & Acknowledgement.
- 2
Review The Advisory
Read the requirements about backflow prevention, testing, costs, and water rates.
- 3
Complete And Sign
Enter the property address, print the owner's name, and have the owner sign and date the acknowledgement.
- 4
Submit To The City
Send it to the City before the backflow prevention permit is issued and the irrigation meter is installed.
Frequently asked questions
- Do I need a notary for the Irrigation Meter Acknowledgement?
- No. The owner signs and dates this acknowledgement without a notary; the document does not describe a notarized or sworn attachment.
- How do I submit the Irrigation Meter Acknowledgement?
- The City must receive the signed acknowledgement before issuing the backflow prevention permit and installing the irrigation meter. The form lists the Building Division address and email.
- When must the City receive this acknowledgement?
- The form says the owner-signed acknowledgement must be received before the City issues the backflow prevention permit and installs the irrigation meter.
- What information does the acknowledgement ask for?
- It asks for the property address, the owner's printed name, the owner's signature, and the date.
Need something notarized?
This Irrigation Meter Advisory & Acknowledgement doesn’t need a notary — but if you have another Lake Havasu City form that does, a commissioned online notary can help.