Intent to Serve Request

Please use this Intent to Serve Request form to determine if the property in question is within the City of Goodyear service area or if a commitment from the City to serve an area outside of the City’s service area is required. This form is not intended for Maricopa County Environmental Services Division (MCESD) Approval to Construct (ATC), Sewer Capacity, Sanitary Facilities for a Subdivision (Health Certificate), or Sewer availability requests.

1

Contact Person

 *

Contact Person

Name:	Phone:	Email:
Address:	City:	State:
Zip:

2

Legal Owner/Agent 

Legal Owner/Agent

Name:	Phone:	Email:
Address:	City:	State:
Zip:

3

Please check the box(es) for exactly what you are requesting:

 *

Please check the box(es) for exactly what you are requesting:

Intent to Serve - Water from City of Goodyear

Intent to Serve - Sewer from City of Goodyear

Other

4

Briefly describe the reason you are making this request:

(Example reasons: At the request of MCESD for a septic permit, at the request of a lender for a bank loan, etc.)

Briefly describe the reason you are making this request: (Example reasons: At the request of MCESD for a septic permit, at the request of a lender for a bank loan, etc.)

5

Property Address (and/or name of related development):

Property Address (and/or name of related development):

Address:	Assessor’s Parcel No:
Major Cross-Streets:	Water is currently provided by:

6

Sewage currently flows to: 

Sewage currently flows to:

Septic Tank

Treatment Facility

7

Additional Information:

Additional Information:

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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