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We cannot accept any applications any further in advance than 5 business days. If you submit any sooner, your application will be rejected.
Enter the Date of Birth for the Primary Applicant.
Enter phone number for each occupant over the age of 18.
You will still be required to provide your Social Security Number and those of any additional occupants prior to establishing any water service.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
This field is not part of the form submission.
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