Connect Service

Please fill out this form about the last resident and yourself as completely as possible.

If you have questions regarding this change please contact Kathy Millick at 922-5443 extension 225.

Note: This form is intended to begin the process of starting service and is in no way a contract or binding agreement.

I am the *
Owner Property Manager Renter
Service of Address *Address where Sewer and/or Water services are provided
Owner / Property Manager Name *
Owner / Property Manager Phone *
Owner / Property Manager Billing Address *
Owner / Property Manager Email
Renter Name *Please put NA if there is no renter
Renter Phone *Please put NA if there is no renter
Renter Billing Address *If service address is the same as billing then write "same"
Renter Email
Effective As Of *Please Enter a Date
Additional Contact Info
Additional Comments