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Plan Application Form

    An $10 fee is payable for all new applications.

    * indicates required field

    Property and Owner Details

    Lot Number

    Plan Number

    * Unit/Street Number

    * Street Name

    * Town

    * Post Code

    * Name of Current Owner

    Applicant Details

    * Applicants Name

    * Contact Number

    * Postal Address

    * Email Address

    Fax Number

    Information required for Sewer Services
    Yes

    Information required for Water Services
    Yes

    * Application Date

    Preferred Delivery Method

    * Delivery Method

    Additional Comments

    Fees

    * Method of payment ($10.00 per property).
    Please contact East Gippsland Water for payment processing.

    Name of Card Holder

    * Contact Number - Business Hours)