RESIDENTIAL WATER/SEWER SERVICE APPLICATION

* REQUIRED fields
Contact Information
  1. Applicant *
  2. Billing Address *
  3. City, State Zip *
  4. Phone # *  Enter a valid phone number in the form xxx-xxx-xxxx
  5. Email Address *
Service Location
  1.  Same as above

    Name of Business / Customer Name *

    Service Address *

    City, State Zip *
  2. Lot No
Service Details

  1. Domestic Meter
  2. Irrigation
  3. Sewer
  4. Comments