Stop Service Agreement Form

All fields with an asterisk * are required.

SERVICE INFORMATION
(Last day of lease or closing date for sale)
If needed, please describe any additional information about the effective date.

Once we turn the water off at the street the utility account will continue to be billed base fees. These charges are to help maintain the infrastructure. The City charges a $35.00 disconnect/restore fee for this service.

YOUR FORWARDING INFORMATION

 

 

WHO IS TAKING OVER RESPONSIBILITY OF THE SERVICE ADDRESS
AUTHORIZATION TO STOP SERVICE

Electronic signature agreement. By selecting the "I Accept" button, you are signing this agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions. You further agree that your use of a key pad, mouse or other device to select an item, button, icon or similar act/action, or in accessing or making any transaction regarding any agreement, acknowledgement, consent terms, disclosures or conditions constitutes your signature (hereafter referred to as "E-Signature"), acceptance and agreement as if actually signed by you in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature. You also represent that you are authorized to enter into this Agreement for all persons who own or are authorized to access any of your accounts and that such persons will be bound by the terms of this Agreement.