Request for Service Availability Letter
Date:
To request a service availability letter, complete this form then click on the “Submit ” button at the bottom of the page, or print the completed form and fax to us at (719) 668-8276. You may also send a map or other attachments via fax or by
e-mail.
The asterisk (*) means required. Use your Tab key or mouse (not the enter key) to navigate through the form.
*Contact Name:
*E-mail:
*Address:
*City:
*State:
*Zip:
*Phone Number:
*Fax Number:
*Project Name or Description:
*Acreage of property:
*Project Address and/or legal description (include Section, Township & Range):
*Tax Schedule Number: (See the
County Assessor's Web site
) and/or nearest street intersection
Company name and address to which the letter is to be sent:
*Company Name:
*Address:
*City:
*State:
*Zip:
*Attention:
Company name and address to appear on letter (if different from above)
Company Name:
Address:
City:
State:
Zip:
Attention:
What utilities are needed for this letter? (please check all that apply)
Water
Wastewater
Natural Gas
Electric
*Request Letter By:
(date)
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