Online Form - Facility/Connection Fees

Facility/Connection Fees Application for Utilities Permit
This application identifies the type of service(s) at your installation and will assist the Town of Kilmarnock staff in determining the Facility and Connection Fees. For questions or further assistance, contact Marshal Sebra, Planning and Zoning Director, msebra@kilmarnockva.com, 804-435-1552 x32 or Cindy Balderson, Town Clerk and utilities support, cbalderson@kilmarnockva.com, 804-435-1552 x23.
Owner*
First Last
Phone Number*
Permanent Address*
Street Address Address Line 2 City State ZIP Code
Email Address*
I (we) hereby make application to connect to and/or construct utility services in a building(s) to be constructed, under construction, or altered.
Location of Building
Street Address Address Line 2 City State ZIP Code
Tax Map Number
Lot Number
Development Name
Type of Installation
Residential
Commercial
Restaurant
Connection Type
Fire Suppression
- Yes
- No
Irrigation
- Yes
- No
Size of Meters
5/8” or 3/4”
1”
1 1/2”
2”
3”
4”
6”
*FACILITY/CONNECTION FEES MUST BE PAID PRIOR TO ZONING PERMIT APPROVAL
Consent*
I (we) hereby certify that I (we) have read and understand the requirements of The Town of Kilmarnock ordinances pertaining to this application for utility services as stated online and hereby agree to fully conform to all town ordinances pertaining to these utility services. There may be additional requirements based on the circumstances of the given project. Users are encouraged to review all the water and sewer guidelines in the Town Code at www.kilmarnockva.com/town-code/. Utilities are addressed in Section 50*
Sign Here
First Last

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Facility/Connection Fees Application for Utilities Permit

Type of Installation

Size of Meters

*FACILITY/CONNECTION FEES MUST BE PAID PRIOR TO ZONING PERMIT APPROVAL

Town of Kilmarnock

Residents

Visitors

Businesses

Government

About