WATER SERVICE APPLICATION
A $100 NON-REFUNDABLE /NON-TRANSFERABLE SERVICE FEE IS DUE AT TIME
OF APPLICATION
NAME___________________________________________ DATE OF BIRTH________
SERVICE ADDRESS__________________________________________________
TELEPHONE_________________ OWN RENT LANDLORD_________________________
MAILING ADDRESS IF DIFFERENT FROM SERVICE___________________________
E-MAIL_________________________DRIVERS LICENSE_____________________
PRESENT EMPLOYER_______________________ADDRESS_____________________
JOINT ACCOUNT INFORMATION
NAME_____________________________________DATE OF BIRTH_______________
RELATIONSHIP TO APPLICANT________________ DRIVERS LICENSE__________________
*SHOULD APPLICANT ACCOUNT BE TURNED OVER FOR COLLECTIONS, THE APPLICANT ACCEPTS
ALL RESPONSIBILITY FOR PAYMENT OF THE COLLECTION COSTS.
SIGNATURE____________________ DATE_______
GARBAGE PICKUP IS EVERY TUESDAY, ROUTE STARTS AT 7:00 A.M. GARBAGE
SHOULD BE AT THE END OF YOUR DRIVEWAY IN GARBAGE CANS. THE FEE IS
$10.50 EACH MONTH, THIS FEE IS INCLUDED IN YOUR WATER BILL.
HOUSEHOLD WASTE ONLY. NO YARD WASTE, NO FURNITURE, NO
ELECTRONICS, NO LIQUID OF ANY KIND AND NO TIRES OF ANY KIND.
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