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Application for Installation of Water / Sewer Service
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Applicant's Name
First
*
Last
*
Service Address
House #
*
Street
*
City
*
Lot #
LRK / Parcel ID
Contact Information
Phone #
*
Email Address
*
Billing Address
House #
Street
City
State
Property Owner's Name
First
*
Last
*
Service & Meter Size Requested
Water Only
Pipe Diameter
Select Size
Standard 3/4
Other
Sewer Only
Pipe Diameter
Select Size
Standard 4
6
Water & Sewer
Pipe Diameter
Select Size
Standard 3/4
Other
Pipe Diameter
Select Size
Standard 4
6
Irrigation
Pipe Diameter
Select Size
Standard 3/4
Other
Other
Type of Account
Single Family Detached
Multi-Family
Commercial
Other
* indicates required fields.
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