Lumpkin County, GA · Lumpkin County
Approved Private Development Contractor Application
This application lets contractors request approval from the Lumpkin County Water & Sewerage Authority for private development water, sewer, or sewage pump station work.
At a glance
- Issued by
- City of Lumpkin County · Lumpkin County, Lumpkin County, Georgia
- Notarization
- Not required: file this form without a notary.
- Official source
- lumpkincounty.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Contractors use this application to request approval for water, sanitary sewer, and sewage pump station work through the Lumpkin County Water & Sewerage Authority. It asks for company and contact details, license and insurance information, installation experience, and three written references for each utility sought. The Authority requires the application and supporting documents before processing, and accepted contractors serve a one-year probationary period.
Who needs it
Contractors seeking approval to perform private development water, sanitary sewer, or sewage pump station work for the Authority need this application.
How to submit it
Send the completed application and required documents to LCWSA, Attn: Sean Phipps, 194 Courthouse Hill, Annex A, Dahlonega, GA 30533, or email [email protected].
About notarization
This document is signed and dated without a notary; the listed license, insurance, and written references are attachments, with no sworn or notarized step stated.
How to submit this form
- 1
Download the Application
Download the Approved Private Development Contractor Application.
- 2
Complete the Application
Provide company and contact details, license and insurance information, years of installation experience, and references for each utility sought.
- 3
Gather Required Documents
Include a current Georgia Utility Contractor License, a $1,000,000 liability insurance policy, and three written references.
- 4
Submit to the Authority
Send the completed application and documents to LCWSA by mail or email using the contact details on the form.
Frequently asked questions
- Do I need a notary for this application?
- No. The application has a signature and date line but no notary block. It lists a contractor license, liability insurance, and written references as required supporting documents.
- How do I submit the application?
- Send the completed application and required documents to LCWSA, Attn: Sean Phipps, at 194 Courthouse Hill, Annex A, Dahlonega, GA 30533, or email [email protected].
- What supporting documents does the application require?
- The Authority requires a current Georgia Utility Contractor License, a $1,000,000 liability insurance policy, and three written references from another city, county, municipality, or authority.