| Professional
Services, Bid Invitations, Government Record Request and Job
Applications |
| Form
Name |
Form
Description |
Phone
Number |
 |
Request Record |
Request to
Access A Government Record. |
808-245-5408 |
|
Various
Forms |
| Form
Name |
Form
Description |
Last
Updated |
Phone
Number |
|
Notary Jurats |
Sample Notary Sections (jurats) for your notary public to use with
your Department of Water (DOW) documents. If applicable,
please select the notary section to fit your situation and attach
with your other DOW documents. (Revise if necessary to match
your situation.) |
September
2009 |
808-245-5468 |
|
Conveyance
of Water Facility |
Conveying
Private Facility to the Department of Water |
September
2009 |
808-245-5408 |
|
Conveyance
of Water Facility-DSL |
Conveying
a Double Service Lateral with Two Tax Map Key numbers for a Private Facility to the Department of Water |
September
2009 |
808-245-5468 |
|
Elevation
Agreement |
An
ageement stating that the property is at an elevation that the
Department of Water cannot be assured of a dependable water supply
or of adequate service |
September 2013 |
808-245-5419 |
|
Elevation
Agreement for Condominiums |
For
condominium owners. An
ageement stating that the property is at an elevation that the
Department of Water cannot be assured of a dependable water supply
or of adequate service |
September 2013 |
808-245-5419 |
|
Grant
of Easement |
An
agreement to grant, bargain, sell and convey to the Department of
Water an easement in perpetuity |
September
2009 |
808-245-5408 |
|
Right
of Entry |
Temporary
Entry to Land |
September
2009 |
808-245-5408 |
|
Waiver
& Release |
An
agreement stating that no County supplied water service of any
kind exists and acknowledging and accepting the fact that no
County supplied water service may ever exist at the location. |
September 2013 |
808-245-5419 |
|
Waiver
and Release for individual CPR |
Waiver and
Release Agreement for an Individual CPR Unit |
September 2013 |
808-245-5419 |
|
Waiver
of Construction Drawings |
Agreement
to approve water meter service for property, without the
requirement of a construction drawing of the water meter
connections as required under the Rules and Regulations of the
Department of Water |
September 2013 |
808-245-5419 |
|
Non-Development
Agreement |
Agreement
to subdivide property but knowing that the property's existing
water system facilities are inadequate to provide additional water
service |
September 2009 |
808-245-5419 |
|
Cost
Breakdown |
Final cost
breakdown of the water facility that is being conveyed by the
owner to the Department of Water |
January
2002 |
808-245-5419 |
|
Non-Interconnection
Agreement |
No
interconnections between water supplied by DOW's water meter and
water supplied by the private water system exist or shall be
constructed. |
May
2010 |
808-245-5419 |
|
Leak Adjustment Form |
Adjustment Request for Undetected Underground Leaks |
808-245-5458 |
|
BFP Test Form |
Backflow Prevention Test Form |
808-245-5421 |
|
BFP Testers |
APPROVED LIST OF CERTIFIED BACKFLOW PREVENTION ASSEMBLY TESTERS -
Sept. 2016 - List Subject to Change |
808-245-5421 |
|
Various Applications |
|
Apply
for Water Service |
Application
for Water Services |
808-245-5442 |
|
Transfer
of Service Account |
Transfer
the service account to a new owner/renter |
808-245-5442 |
|
Application for Temporary Water Service |
Appliction for Temporary Fire Hydrant Use |
808-245-5430 |
|
New/Renewal Agricultural Application |
Application and Renewal Form for Agricultural Rates |
808-245-5428 |
|
Payment Plan Application |
Application for Promissory Note |
808-245-5428 |
|
|
Automatic Bill Payment (ABP) Form |
The Kauai Department of Water invites you
to select an easy way to pay your water bill with our new Automatic
Bill Payment (ABP) service.
Your participating bank, savings and loan, or credit union
can pay your water bill by deducting the amount due automatically
from your financial account.
Save on writing checks, stamps, and envelopes |
808-245-5442 |
