New Water Service Application – Residential Only

Property Information

Date to Start Water Service*

Service Address*

Mailing Address*

Please indicate if you are:*

How many people are living in the home?*

Customer Information

Customer Name*

Social Security Number*

Phone Number*

Date of Birth*

Driver's License Number*

Email address*

I want to receive e-notifications for my water bill.

Employer*

A spouse/other will occupy the home as well.

Spouse/Other Information

Spouse/Other Name*

Spouse/Other Employer*

Spouse/Other Date of Birth*

Spouse/Other's Driver's License Number*

Spouse/Other's Social Security Number*

Attachments

Copy of Driver's License with photo for each person listed on account.*

Maximum size of 50MB

Copy of Closing Papers*

Maximum size of 50MB

Bank Draft

I want to enroll in direct payment.

Financial Institution Name*

Financial Institution Address*

Account Number*

Type of Account*

Checking

Sabings

Financial Institution Phone Number*

Routing Number*

Name Shown on Account*

Copy of Voided Check*

Note: Continue to pay by check/cash until your bill says "DO NOT PAY."

Legalese

I understand that the City will begin water service by making a physical connection located outside the building or buildings to be served. I understand that the City will not have access to any building served and will not determine if there are any open faucets or water system leaks inside the building. If there are any open faucets or water systems leaks that cause damage to the property, I agree not to hold the City responsible for any damages arising therefrom.

I understand that the City requires a minimum of one working day notice to connect service.

I understand a deposit of not less than $125 is mandatory to establish a new account. A service fee of $15 is also due when setting up new service.

I understand that the City will not initiate service if the meter indicates water is running.

I want my address, telephone number and Social Security number to be kept confidential.

Applications received by 4:00PM, Monday through Friday, will have water service started the next business day by 5:00PM. Applications received after 4:00PM or on the weekend will have service started within two business days by 5:00PM.

This field should be left blank