Plumbing Application

User ID# (if applicable)        
Subject: 

Property Owner Information
* First Name:                 
* Last Name    
(This e-mail address will receive electronic notifications, it does not have to belong to the property owner)     
* E Mail:          
* Phone        
* Address1               
   Address2      
* City:                 * State  
* Zip             

Mailing Address Of Applicant If Different than Above
Address1               
Address2       
City                 State    
Zip

Permit Information                                                            
This Application is for:              Please Select New Plumbing Relocated Plumbing    
Structure To Be Served:  Please Select Single Family Dwelling Modular or Mobile Home Multiple Family Dwelling Other (Specify Below)

If Other Structure Above Please Specify:

Plumbing To Be Installed By:      Please Select Master Plumber Oil Burnerman MFG'D Housing Dealer/Mechanic Public Utility Employee Property Owner
License #:
Plumber's E-Mail
Plumber's Phone
Address
City      State
Zip

Hook-Up & Piping Relocation (Maximum of 1 Hook-Up) 
Option A: Hook-Up to a public sewer in those cases where the connection is
not regulated and inspected by the local Sanitary district.
Option B: Hook-Up to an existing subsurface waste water disposal system .
Option C: Piping relocation of sanitary lines, drains, and piping without new fixtures.
Please Select Option A Option B Option C

Permit Required:
Plumbing shall not be installed until the applicant has been notified that a Permit has been approved.  The Permit shall authorize the owner or installer to install the plumbing in accordance with this application and the Maine Plumbing Rules