Form Center

Search Forms:

Search Forms Select a Category

All Categories
Administration
Building Department/Code Enforcement
Business Advisory Forms
City Clerk

Employment
Finance Department
Information Technology
Planning Department

Public Works
Recreation
Utilities
West Melbourne Police Department

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Water/Sewer Disconnection Form

Sign in to Save Progress

This form has been modified since it was saved. Please review all fields before submitting.

TODAY'S DATE*
TODAY'S DATE
FINAL ACCOUNT
ACCOUNT NAME*
ACCOUNT NUMBER*
PROPERTY ADDRESS*
West Melbourne, FL 32904
TURN OFF DATE*
TURN OFF DATE
(Water cannot be turned off on weekends or holidays)
EMAIL
FORWARDING STREET ADDRESS*
CITY, STATE, ZIP*
PHONE NUMBER*
NOTE:
The Post Office will not forward your bill or deposit. You must change your address with the Utility Department.
SIGNATURE OF ACCOUNT HOLDER(S)*
(Type your name/s as your signature)
DATE*
DATE
2240 Minton Rd., West Melbourne, FL 32904
Phone: 321-837-7750 Fax: 321-768-2390