Jerome, AZ · Yavapai County
Application for Piped Sewer Connection
Jerome property owners use this application to request a piped sewer connection and provide property, contact, intended-use, and service-size information.
What this form is
This application is for property owners requesting a piped sewer connection from the Town of Jerome. It asks for the owner’s name and addresses, contact information, parcel number, intended property use, and service size. The form includes a Town Code fee excerpt and requires the applicant to certify the information and agree to notify the Town in writing if the intended use changes.
Who needs it
A property owner requesting a sewer hookup from the Town of Jerome should complete this application and make the request in writing.
How to submit it
The form says sewer hookup requests must be made in writing to the Town Manager. It lists Town of Jerome, P.O. Box 335, Jerome, Arizona 86331.
About notarization
No notary is required; the applicant signs and dates the form, which also includes a witness line.
How to submit this form
- 1
Download the Application
Download the Town of Jerome Application for Piped Sewer Connection.
- 2
Complete the Form
Enter the property owner, address, contact, parcel, intended-use, and service-size information requested.
- 3
Review the Fee Excerpt
Review the attached Town Code excerpt for the applicable hookup fee; materials, equipment, and labor are charged in addition.
- 4
Sign and Submit
Sign and date the application, then make the sewer hookup request in writing to the Town Manager at the address listed on the form.
Frequently asked questions
- What is the Application for Piped Sewer Connection?
- It is the Town of Jerome application for property owners requesting a piped sewer connection. It collects property, contact, intended-use, and service-size information.
- Who should complete this application?
- The form identifies the property owner as the applicant and says sewer hookup requests must be made in writing to the Town Manager.
- Do I need a notary for the Piped Sewer Connection Application?
- No. The applicant signs and dates the form, which also includes a witness line; it does not require a notary.
- How do I submit the Piped Sewer Connection Application?
- The form says to make the sewer hookup request in writing to the Town Manager. It lists Town of Jerome, P.O. Box 335, Jerome, Arizona 86331.