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  • 4 Way Ranch Service Request

  • Instructions: Please complete this application in its entirety, once you submit an email will go to brenda.j@wsdistricts.co. Your Social Security Number (SSN) will be used for identification purposes. Applications for utility service are typically processed within five (3) business days from the day of receipt. You will have the ability to download a copy of this form once submitted. Denied applications will have three (3) business days to complete application requirements. You may also apply for service by calling 719- 447-1777. If you do not wish to provide your SSN, we will take your application at our office location at 614 N Tejon St., Colorado Springs, CO 80903. It is the tenant's responsibility to notify the District Manager to disconnect service when moving from this location.

  • Property/ Owner(s) Information

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  • Emergency Contact Information

  • I hereby certify that I have read the information on this form and understand its contents, and that the statements I have made are accurate to the best of my knowledge.

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  • If you choose to email your application, you willingly accept all risks related to intercept, misaddressed, misdelivered, or otherwise unsecured transmissions.

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  • Office Use Only:

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