The Service Effective Date* requested below will determine the date of the beginning or end of your service. It is also the date we will read your water meter. Water meters are read M-F from 8am to 5pm. Please allow 1 to 3 days, from the Effective Date, for meter reading. Thank you!
ALERT: The form below is to be used for New and Discontinued Service requests. Please submit a separate form for each type of service
| TYPE OF SERVICE REQUEST | |
| New Service | Yes No |
| Discontinue Service | Yes No |
| Do you own property? | Yes No |
| NEW SERVICE REQUEST | |
| New Service Property Address: | |
| Is this a new house? | Yes No |
| New Service Effective Date: | * |
| DISCONTINUE SERVICE REQUEST | |
| Discontinue Service Address: | |
| Forwarding Address - for Final Bill | |
| Forwarding City, State, and Zip Code | |
| Discontinue Service Effective Date: | * |
| BILLING INFORMATION | |
| Last Name: | |
| First Name: | |
| Additional Name - (Spouse, etc.): | |
| Mailing Address or PO Box: | |
| City, State and Zip Code | |
| Phone Number | |
| Email Address | |
| Transfer ACH payment to new address? | Yes No |