URC Preliminary Verification Form

URC Preliminary Verification Form
Please Select Your County*

Salt Lake CountySummit CountyUtah CountyWeber CountyNone of the Above

Is your zipcode 84060?*

YesNo
Do you live in unincorporated Weber County?*

YesNoI do not know
Cottonwood Heights - Does your address fall within Cottonwood Heights City Limits? Please see zoning map above.*

YesNo
Sandy - Are you a Sandy Water Utility Customer? Please see map for service area*

YesNo
West Jordan - What is your water account number?*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*

Confirmation Emailexample@example.com
Should be Empty:

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