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APPLICATIONS AND FORMS

 

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Applications/Forms and Services

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The following table displays a description of applications and forms used by the Department.  It will also include requests for Professional Services, Bid Invitations, Govt Record Request, and Job Openings.  The forms are only available in Adobe Acrobat format, and requires Acrobat Reader 5.0 or greater.  Follow the link below to download the latest copy of the Acrobat Reader.  Most of the Engineering Forms/Applications below are now interactive.  You can fill the forms out on-line, print them out and then mail/fax/hand deliver them to the department.

 

 



This file format requires the free Acrobat Reader from Adobe.



Form Name Form Description Email

Request Record

Request to Access A Government Record (DOW Fee Schedule) governmentrecords@kauaiwater.org

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.) adminsupport@kauaiwater.org

Conveyance of Water Facility

Conveying Private Facility to the Department of Water adminsupport@kauaiwater.org

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 adminsupport@kauaiwater.org
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

adminsupport@kauaiwater.org
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 adminsupport@kauaiwater.org
Grant of Easement An agreement to grant, bargain, sell and convey to the Department of Water an easement in perpetuity adminsupport@kauaiwater.org
Right of Entry Temporary Entry to Land adminsupport@kauaiwater.org
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. adminsupport@kauaiwater.org
Waiver and Release for individual CPR Waiver and Release Agreement for an Individual CPR Unit adminsupport@kauaiwater.org
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 adminsupport@kauaiwater.org
Non-Development Agreement Agreement to subdivide property but knowing that the property's existing water system facilities are inadequate to provide additional water service adminsupport@kauaiwater.org
Cost Breakdown Final cost breakdown of the water facility that is being conveyed by the owner to the Department of Water adminsupport@kauaiwater.org
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.  adminsupport@kauaiwater.org
Leak Adjustment Form Adjustment Request for Undetected Underground Leaks   In - Person Only (Notary Req)
New Service Lateral Request for new water meter service connection (new service lateral) adminsupport@kauaiwater.org
BFP Test Form Backflow Prevention Test Form wrp@kauaiwater.org
BFP Testers APPROVED LIST OF CERTIFIED BACKFLOW PREVENTION ASSEMBLY TESTERS - 2021 - List Subject to Change wrp@kauaiwater.org
Apply for Water Service Application for Water Services (Existing Water Meter Box) billing@kauaiwater.org
Transfer of Service Account Transfer the service account to a new owner/renter billing@kauaiwater.org
Application for Temporary Water Service Appliction for Temporary Fire Hydrant Use billing@kauaiwater.org
New/Renewal Agricultural Application Application and Renewal Form for Agricultural Rates billing@kauaiwater.org
Payment Plan Application Application for Promissory Note billing@kauaiwater.org
  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  billing@kauaiwater.org

 

 

 

 

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