Request for Disconnect of Services **NOTE: If you are needing to temporarily disconnect your irrigation meter for the season, fill out the Seasonal Irrigation Form instead. Otherwise, proceed with this form.** **If there are two people listed on your bill, please fill out this form using the primary account holder’s name and information (the first name listed on the bill).**Today's Date *Requested Date of Disconnect *We require at least one business day’s notice. We do not do same-day disconnects.Customer Name (as appears on bill) *Service Address * Forwarding Address for Final BillForwarding Street Address *City *State *Zip Code * Driver's License Number of Account Holder *Last 4 Digits of Social Security Number or Tax ID *Phone Number *Email Address *By accepting below, the customer understands there will be a final bill sent to your forwarding address approximately 30 days (+/-) after the date of disconnect, and the final bill will be due on the normal due date. The amount paid to have the water and/or sewer service connected originally was only a service fee and is non-refundable. *I accept these terms.Submit
