Clementon, MT · Camden County
Water Service Line Identification Property Owner Refusal Form
Property owners use this form to document that access was denied when the Borough of Clementon attempted to identify a water service line.
What this form is
The form documents the Borough of Clementon’s attempt to identify the water service line at an address and the homeowner’s denial of access. It is for use when a property owner refuses access for that identification. It asks for the property address, representative’s name, date and signature, utility representative details, owner contact information, and the reason for refusing access.
Who needs it
A property owner or representative who denied access during the Borough’s attempt to identify the property’s water service line should complete this form.
How to submit it
Email the completed form to [email protected] or drop it off at Borough Hall, 101 Gibbsboro Road, Clementon, NJ 08021, for Tori Kupsey.
About notarization
This form is signed and dated without a notary; it does not identify any attachment or related step that must be notarized or sworn.
How to submit this form
- 1
Download The Form
Download the Water Service Line Identification Property Owner Refusal Form.
- 2
Complete The Form
Enter the address, representative’s name, date and signature, utility representative details, owner contact information, and reason for refusal.
- 3
Prepare Service Line Information
The form’s instructions say to have a clear picture of the service line material or have one on your cellular device.
- 4
Submit The Form
Email it to [email protected] or drop it off at Borough Hall for Tori Kupsey.
Frequently asked questions
- What is the Water Service Line Identification Property Owner Refusal Form?
- It records the Borough’s attempt to identify a water service line at an address and the homeowner’s denial of access. It asks for contact details and the reason for refusal.
- Who should complete this form?
- A property owner or representative should complete it when access was denied during the Borough’s attempt to identify the property’s water service line.
- Do I need a notary for the Water Service Line Identification Property Owner Refusal Form?
- No. The form is signed and dated without a notary, and it does not identify an attachment or related step that must be notarized or sworn.
- How do I submit the Water Service Line Identification Property Owner Refusal Form?
- Email it to [email protected] or drop it off at Borough Hall, 101 Gibbsboro Road, Clementon, NJ 08021, for Tori Kupsey.