PLEASE COMPLETE THE FORM BELOW IF YOU ARE A CONTRACTOR OR LOT OWNER,
and need to apply for new service.
All fields (except Comments) are required. *
Due to the size, type of service, location of the water main, and the nature of our service area we need to do an on-site visit to the service location before we can give you an estimate on the connection cost. Filling out the form below will start the process. Once an estimate is completed you will be contacted. Installation will be scheduled when payment is received. We only accept checks or money orders for payment, no cash or credit cards accepted.
There is a 2-4 week timeframe prior to actual installation after payment is received. Also, in rare circumstances, a state permit may have to be procured, which can sometimes extend the installation time beyond our control.
New Service Address: *
Parcel Number: *
Customer Name: *
Customer Driver's License No: *
Billing Address: *
City, State, ZIP: *
Customer Phone: *
Customer Email: *
Requested Install Date: *
Comments (optional):
Security Measure