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Water / Sewer Tap Application Form

Form fields marked with * (asterisk) are Required

Please Enter Your First Name.

Please Enter Your Last Name.

Please Enter Your Address.

Please Enter The Service Address

A valid Phone Number is required. Dashes are allowed.

Requested Tap Services:

This will be figured and priced according to cost and labor

Agreement

You will receive an invoice from the City for the requested services. When the invoice is paid, this request will be honored if installation takes place within 364 days from date of request. Upon expiration of this request, the customer can request a refund of the amount paid or apply the amount paid to the current pricing rates.

Please Check the Agreement Checkbox.

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