PBWR New Water and Wastewater Service Application

Permian Basin Water Resources

serving Park Water Company and Greenwood Water Corporations 2409 S. County Road 1110 Midland, TX 79706
NEW WATER AND WASTEWATER SERVICE APPLICATION
To start new service for an existing home, please complete this application and use the submit button at the end of this application to electronically send your application to our Customer Service team. Please note that service cannot be placed into your name more than five days in advance.

All submitted applications received by 3:00 PM will be processed the same business day. Submissions received after 3:00 PM will be processed the following business day.

Once your application has been processed you will receive an email from PBWR@myUtilityDirect.com that will include account information, including instructions for registering for online access. If you do not receive an email please check your SPAM or Junk folders.

All accounts will be charged a $35.00 Transition Fee per service billed. This charge will be included on your first statement.

If you have any questions or need assistance with filling out this application, please contact our customer service department at 888-812-6268
APPLICANT INFORMATION
Applicant Name*
Spouse Name
Mailing Address
City
State
Zip
Home Phone
Cell Phone
Email*
example@example.com
Drivers License Number*
State Issued*
Name of Additional person authorized to make changes to this account
Email
example@example.com
Phone Number
Service Address*
Service Start Date*

MonthDayYear
Service City*
Zip Code*
State
Approval Applicants Name (Note: Form must be completed by applicant only
Signature*

Clear
Date*

MonthDayYear
Date
TO BE COMPLETED BY PERMIAN BASIN
Meter Serial Number
Meter Read at move in
Should be Empty:

Permian Basin Water Resources

NEW WATER AND WASTEWATER SERVICE APPLICATION

APPLICANT INFORMATION

TO BE COMPLETED BY PERMIAN BASIN