Contact Information
Applicant/Customer
*
required
Billing Address
*
required
City, State Zip
*
required
Phone #
*
required
Phone formmat xxx-xxx-xxxx
Email Address
*
required
invalid
Service Location
Same as above
Name of Business / Customer Name
*
Service Address
*
City, State Zip
*
Subdivision/Project Name
Lot No
Service Details
Domestic Meter
Service(s) is required.
None
3/4"
1"
1 1/2"
2"
Irrigation
None
3/4"
1"
1 1/2"
2"
Tap needed
Sewer
6" Sewer Tap Installation
Residential Impact Fee (SDF)-Required for initial connection to sewer
Comments