River Rouge, MI · Wayne County
Lead Water Service Line Consent and Release Form
Property owners use this agreement to authorize the City of River Rouge to replace a private lead water service line on their property.
What this form is
This agreement authorizes the City to replace a private lead water service line from the water main to at least 18 inches inside the home or to the meter, at no cost to the homeowner. The document says property owners must sign and return it to allow the contractor to enter private property and connect the new line to existing plumbing. It asks for the property address and each owner's signature, printed name, email address, and phone number.
Who needs it
Property owners whose homes are included in the 2025 Lead Water Service Line Replacement Program must sign to permit work on their private property.
How to submit it
Send a scan or picture of the completed consent form to [email protected]. For questions, contact Hennessey Engineers at (734) 759-1600.
About notarization
This document is signed without a notary; each property owner signs and dates the agreement, and no notarized or sworn attachment is identified.
How to submit this form
- 1
Download the Form
Download the Lead Water Service Line Consent and Release Form.
- 2
Complete the Agreement
Enter the property address and each owner's requested information, then sign and date the agreement.
- 3
Gather Attachments
The document does not specify any required attachments.
- 4
Send the Completed Form
Email a scan or picture of the completed form to [email protected].
Frequently asked questions
- What does the Lead Water Service Line Consent and Release Form authorize?
- It authorizes the City to replace the private water service line and permits the contractor to enter the property to complete the work and connect the new line.
- Do I need a notary for the Lead Water Service Line Consent and Release Form?
- No. Property owners sign and date the agreement; the document does not identify a notarized or sworn attachment.
- How do I submit the Lead Water Service Line Consent and Release Form?
- Send a scan or picture of the completed form to [email protected]. The document lists Hennessey Engineers at (734) 759-1600 for questions.
Need something notarized?
This Lead Water Service Line Consent and Release Form doesn’t need a notary — but Michigan residents can notarize other documents online with a commissioned online notary.