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Application for Reactivating Utility Services
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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
PLEASE NOTE:
All paperwork and deposits must be in our office by 3pm on date requested to start service.
Application Date:
*
Application Date:
Start Date:
*
Start Date:
Please Note: Start date cannot precede application date, nor can Start Date occur on a weekend or holiday.
Utility Service Request Type
*
Residential
Commercial
Own/Purchased
Rent
Address for Service:
*
Residence*
*
Full-Time Residence
Part-Time Residence
Is Mailing Address different than Service Address?
*
Yes
No
Mailing Street
*
Mailing City
*
Mailing State
*
-- Select One --
AK
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AR
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CA
CO
CT
DE
FL
GA
HI
IA
ID
IL
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KS
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LA
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ME
MI
MN
MO
MS
MT
NC
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NJ
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OH
OK
OR
PA
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SC
SD
TN
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UT
VA
VT
WA
WI
WV
WY
Mailing Zip
*
CONTACT INFORMATION
First Name
*
Last Name
*
Home Phone
Mobile Phone
Email Address
Would you like to receive paperless billing to the email address above?
Yes
No
ATTACH PHOTO ID
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!
Applicant Signature (Type your name here as signature)
*
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