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Water Main Notification
A. General Information
For assistance completing this form or for more information, please contact our Client Service Office:Email: [email protected] (toll free in North America): 1-800-567-4224Tel (Regina): 306-787-2584
For assistance on technical aspects related to notification requirements please contact the Water Security Agency:Email: [email protected]
Once completed, this form can be submitted through:Email: [email protected]: (306) 787-0780Mail: Environmental and Municipal Management Services DivisionEngineering Approvals UnitWater Security Agency420 – 2365 Albert StreetRegina, SK S4P 4K1
June 2015 | CSB | CSB25002
Water Security Agency
This form is to be used to notify the minister, in accordance with section 1-3 of the Water Main Chapter of the Saskatchewan Environmental Code, when constructing a water main to be used by a municipality with a population of at least 5,000 persons. No person shall commence work on the construction of a water main unless that person has notified the minister and received a notification number from the minister. To ensure a timely response, it is important that the form includes all the necessary information.
Organization Name
B. Contact Information
Legal Business Name
Business Number
Contact Person
Address
City
Country
Province Postal Code
Mailing Address Same as above Different from above:
Address
Address
City
Country
Province Postal Code
Contact Details
Phone (work)
Phone (mobile) Email
Preferred Method of Contact Phone Email Mail
1 of 2
2 of 2
Construction of the water main will be in accordance with Part 1 and:
C. Compliance Information
Part 2 (Alternative Solution)
Part 3 (Acceptable Solution)
Estimated Cost of Project
D. Project Details
Anticipated Start Date
Anticipated Construction End Date
Name of Consultant/Engineer
Consultant/Engineer Phone Number
City
Enter the geolocation
Please provide a brief description of what the works will consist of and how
they are intended to be operated.
E. Documentation
Signature of Applicant Date of Application
H. Certification
By checking this box, I certify that the information provided on this form is complete and accurate to the best of my knowledge.
The following documents are submitted with this notification (where applicable):
environmental protection plan (required for alternative solution)
certificate from a qualified person for environmental protection plan (required for alternative solution)
water main design plan (required for acceptable solution)
certificate from a qualified person for water main design plan (required for acceptable solution) other
(e.g. parcel number, civic address, latitude/longitude location)
