Note: If you are applying for a NEW water and/or recycled water connection, this form must be submitted via a Coliban Water registered Quick Connect Agent. Applications for new sewer connections or amendments to existing water/recycled water/sewer connections can be submitted direct to Coliban Water. See Quick Connect Agent contact details here. Complete this form if you require Coliban Water to consider your application for:
• Sewer connection • Changes to existing connection • Fire service • Un-serviced structure (e.g. shed or carport) • Alteration to existing services
Please Note: A customer contribution fee may apply to an existing lot if it has never been serviced. The Landowner can contact us on 1300 363 200 for more information.
Please Note: Do not enter spaces between digits.