Forms

Water and Sewer Application

Responsibility Start Date * Required
MM slash DD slash YYYY
Name * Required
First Middle Initial Last
Employer
Service Address * Required
Include: House Number, Street and Apt # (if applicable)
Different mail address?
- My mailing address is different than the above service address
Mailing Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Primary Phone Number * Required
Alternate Phone Number
Email
Previous Nevada Address (If Applicable)
Spouse Name
First Middle Initial Last
List names of other occupants. Do not list any minors.
Do you own or rent this property? * Required
- Own
- Rent
Landlord Name * Required
Landlord Phone * Required
The undersigned customer agrees to comply with the city code governing utility management.

If this is an application by an existing or former customer or occupant, the customer agrees that any balance due to the city by the customer or other occupant at the address or other occupant at the same address on a previous or existing water and sewer account will be added to the bill for the new service which the customer agrees to pay.
Applicant Signature * Required
Upon form submission: There is a standard refundable deposit of $75 due to secure your utility. If you need assistance with this, please reach out to the Utility Clerk.
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