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2. 
3. Application for Reactivating Utility Services
   
   1. Completed, dated and signed service application.
   2. Copy of valid applicant's government-issued identification; such as state drivers license, passport, etc.
   3. Deposit amounts are as follows (customer service will call you for payment):
   

   • $50.00 Water Deposit (3/4" Connection)
   • $50.00 Sewer Deposit (3/4" Connection)
   • $30.00 Non-Refundable Service Fee

            $130.00 Total to reactivate service
5. PLEASE NOTE:
   All paperwork and deposits must be in our office by 3pm on date requested to start service.
7. Application Date:*
   Application Date:
8. Start Date:*
   Start Date:
   Please Note: Start date cannot precede application date, nor can Start Date occur on a weekend or holiday.
10. Utility Service Request Type*

    1. Residential

    1. Commercial

    1. Own/Purchased

    1. Rent
12. Address for Service:*
14. Residence**

    1. Full-Time Residence
    2. Part-Time Residence
16. Is Mailing Address different than Service Address?*

    1. Yes

    1. No
18. Mailing Street*
20. Mailing City*
21. Mailing State*
    -- Select One --AKALARAZCACOCTDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY
22. Mailing Zip*
24. CONTACT INFORMATION
26. First Name*
27. Last Name*
29. Home Phone
30. Mobile Phone
32. Email Address
34. Would you like to receive paperless billing to the email address above?

    1. Yes

    1. No
36. ATTACH PHOTO ID
38. PLEASE NOTE:
    The account must be closed in writing, can be done either in person, email, fax or by mailing a signed letter from the account holder(s) requesting to disconnect the water. The deposit will be applied to your final bill. You will receive a final bill with either a refund or a balance due. If a balance is due, please pay promptly. NO PHONE REQUESTS WILL BE ACCEPTED!
40. Applicant Signature (Type your name here as signature)*
Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit Submit and Print

* indicates a required field