WATER & SEWER SERVICE APPLICATION
A deposit of $200.00 is required for renters.
If water is currently turned off, a $50.00 turn on fee is due before turn on will occur.
Service(s)
will not be transferred
to the new owner's name until:
The service application is completed & returned with supporting documentation, &
The previous owner has contacted the office & made arrangements to settle the final bill and/or any remaining balance.
Type of Account Requested
*
Joint Account (requires ID's & signatures of both individuals):
Individual Account
Do you:
*
Rent:
Own:
Date of Possession or Rental Start Date
*
/
Month
/
Day
Year
Date
Main Account Holder Name
*
Main Account Holder Phone/Cell Phone
*
Main Account Holder Email
*
example@example.com
Service Address
*
Billing Address (if different from service address)
Main Account Holder Employer
*
Co-Applicant Name
Co-Applicant Phone/Cell Phone
Co-Applicant Email
example@example.com
Co-Applicant Employer
Please choose the correct selection(s)
*
I/We verify that I am the owner of the above named property.
I/We understand and agree that my landlord, or the titled property owner, will be given access to my account information without notice.
I/We understand and agree that a delinquent service account may be: a) placed on the tax duplicate of the property owner for collection, in the same manner as taxes and assessments, including any unpaid utility charges for a tenant at the property; b) sent to an agency for collection; and/or c)be subject to water service shut-off for non-payment; and/or d) any other remedy available to the District.
I/We verify that I have rented/leased the above named property from:
Co-applicant Signature
Full Name
Main Account Holder Signature
*
Co-Applicant Signature
Upload a picture of your ID
Take Photo of your ID
Continue
Continue
Should be Empty: