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Apply for Water, Sewer, Stormwater and Trash Service
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Application Date
*
Application Date
Service to begin
*
Service to begin
Applicant
*
Owner
Tenant - $200. Security Deposit required with application, and must be paid by cash, check or money order.
Service Address
*
Mailing Address, State & Zip (if different from service address)
Applicant Name
*
Email Address
Driver's License or ID #
*
Last 4 digits of SSN #
*
Your preferred phone number will be used to contact you in the event of a service interruption, non-emergency matter, or billing issue.
Preferred Phone Number
*
-- Select One --
Cell
Home
Work
Phone number with area code
*
Additional Phone Number
-- Select One --
Cell
Home
Work
Phone number with area code
Applicant # 1 Signature
Applicant Name # 2
Email Address
Driver's License or ID #
Last 4 digits of SSN #
Phone Number, for Applicant #2
Preferred Phone Number
-- Select One --
Cell
Home
Work
Phone number with area code
Additional Phone Number
-- Select One --
Cell
Home
Work
Phone number with area code
Applicant # 2 Signature
Utility Billing and Collections – A $10. application fee will appear on your first Utility Bill. Bills are due the on last business day of the month. If payment is not received by the 1st of the following month, a 10% late fee will be added. If the bill is not paid within 35 days, service will be terminated. There is a $50. reconnect fee.
The $10. application fee will be waived, if the utility account was previously in your name.
Previous Cranberry Township address
Save $1. per month with E-bill and Auto Debit
Bank Name
Bank Account #
Routing #
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