Account Number (required)
I am requesting water turned off for the following reason: (required)
I am selling my home.I am a tenant and I am moving.I am going out of town for an extended period of time.
Date of requested turn off (required)
I, the undersigned, request to have my water turned off by the date listed above. I understand it is by responsibility to request services 1 week (7 business days) prior to needing services turned on. I understand I will have to pay turn off and turn on service charges.
Email (required if you would like to receive confirmation of request)
Today’s Date (required)
Please write your signature in the box below (required)