Land Development

Additional Information

Provide a copy of the following documents:

Plans signed by a registered land surveyor and approved by Tillamook County Planning Department; provide both a hard copy and a digital copy of the layout saved in “.DWG” format
Property’s legal description or a metes and bounds description
Documentation indicating legal party or parties authorized to sign documents

Customer Certification

I certify that the information provided on this form is accurate and complete to the best of my knowledge; and that I own, lease, or have a contract to purchase the property or premises referenced in this request for service or I have been authorized by the owner or lessee to complete this request on their behalf.

Plan of Service and Load Requirements

I acknowledge that I am required to notify Tillamook PUD-Engineering if load requirements at this service location change significantly.

Tillamook PUD conducts routine inspections and monitoring; if load measurements consistently exceed PUD equipment ratings, I will be contacted and could be responsible for the cost of any damages and/or upgrades deemed necessary to ensure the safety and protection of utility equipment and personnel.

Developer / Contact Information
Name*
Company Name
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Daytime Phone*
Cell Phone*
Email Address*
Contact Information
Mailing Address
Same as previous

Street Address Address Line 2 City State ZIP Code
Daytime Phone
Cell Phone
Email
Project Type

Subdivision
Number of Lots
Phase Number
Date Desired
Partition Plat
Number of Lots
Plat Number
Date Desired
Apartment Complex
Number of Units
Number of Buildings
Date Desired
Condominiums
Number of Units
Phase Number
Date Desired
Townhouses/Row Houses
Number of Lots
Phase Number
Date Desired
Project Information
Name of Development*
Who will install conduit and backfill?*
- Applicant
- Contractor
Contractor Name
Contractor Cell Phone
Trench Services
- Electric
- Telephone
- Cable
Other
Contractor Information
Name*
Mailing Address*
Same as previous

Street Address Address Line 2 City State ZIP Code
Daytime Phone*
Email
Written or verbal authorization from the property owner is required if the applicant is a representative and not the legal property owner. Written authorization may be submitted by uploading a copy of the contract between applicant and property owner. Alternatively, the property owner may contact Tillamook PUD Engineering Department at 503-815-8629 to verbally authorize applicant’s request.
Drop files here or

Accepted file types: pdf, jpg, png, Max. file size: 200 MB, Max. files: 5.
Full Name (Customer's Electronic Singature)*
Do you consent to signing this document electronically?*
- Yes
- No
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Email
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Additional Information

Customer Certification

Plan of Service and Load Requirements

Developer / Contact Information

Contact Information

Project Type

Subdivision

Partition Plat

Apartment Complex

Condominiums

Townhouses/Row Houses

Project Information

Contractor Information