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2. 
3. Utility Billing Department
   Fire Hydrant Meter Application
5. Connection Date*
   Connection Date
   Service Connection only Monday-Friday. 24 HR notice is required. No service on holidays.
7. Additional Requests
9. Business Name
11. Customer Name*
13. Government issued PHOTO ID*

    Upload a copy of your ID.

15. Driver's License #*
16. Date of Birth*
    Date of Birth
18. Social Security #*
19. Phone #*
21. Email Address*
23. Mailing Address
25. Purpose of Construction*
27. Where is the location that the water is needed?*
29. Where is the nearest location you want to get the water from?*
31. Will you be moving to various other locations during this time?*
33. Billing Preference*
    -- Select One --Paper BillE-Bill
37. I AGREE TO THE FOLLOWING:*

    Please check all boxes below to comply.

    1. I understand that I must pay the Utility Billing Deposit based on current Ordinance by contacting Utility Billing at 325-646-9700.
    2. I understand that government issued PHOTO IDENTIFICATION is required for connection. A scanned copy or picture is fine.
39. Service Agreement Contract
    Click here to view the Service Agreement Contract
41. Please remember to call our Utility Billing office at 325-646-9700 for payment of deposit for completion of application. Thank you!
43. Customer Signature:*
    By typing your name you agree that you have read and agree to the terms and conditions of the Service Agreement Contract in the link provided above.
Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

* indicates a required field