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Application For New Utility Service

  1. PLEASE READ

    During our City wide Declaration of Emergency, please provide as much information as you can, a copy of the lease, copy of your drivers license, closing papers, etc. Once the Declaration of Emergency is lifted you will be required to resubmit ALL needed documents to our office within 15 days or services may be disrupted.

  2. Commercial Trash Can / Cart Fee

    During the City wide Declaration of Emergency, the monthly commercial rental fee is $35. We are not able at this time to fully discontinue service if requested. Any request to stop trash pickup may result with the can / cart being left on site. Extra pickups will result in additional fees.

  3. Residential Service Fees

    Residential Water $65, Gas $85, Both $120

  4. Commercial Service Fees

    Commercial Water $80, Gas $100, Both $144

  5. GAS / WATER Service*

    Select which service you are activating. Select both if you are activating gas and water at the same location. NOTE: You must be home for gas service.

  6. Your first name.

  7. Your last name.

  8. First letter of your middle name.

  9. Enter your social security number

  10. Please provide the street address of the location where service is to be located

  11. Do you have a trash cart or can at this address

    Is there a trash can or cart at the service activation address?

  12. Please provide the billing address for the account.

  13. City of billing address

  14. State of billing address

  15. Zip code of billing address

  16. The date your where born.

  17. A valid email address.

  18. Place of employment.

  19. Undersigned agrees and acknowledges that the current City Ordinance, rules and regulations to Utilities are hereby incorporated in to this agreement by reference thereto as if set verbatim herein.

  20. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  21. THE FOLLOWING IS REQUIRED TO OBTAIN SERVICE*

    You must provide the following information to be eligible for service activation.

  22. Are you a "Public Emplyee" as defined under O.C.G.A Sec. 50-18-72(a)(21)

    This includes employees of the State of Georgia, its agencies and commissions; any Georgia county or city and their agencies and commissions; other political subdivisions; teachers in public, charter and nonpublic schools; and employees on certain early care and education programs?

  23. Information PLEASE READ

    For GAS service someone, 18 years or over, must be at the address in order to have the gas turned on. If new appliances or repairs have been added to the gas system, you MUST include the information on the application. An inspection may be required before activation. For Water service you must insure no lines are open (faucets, spigots etc. ) Service will not be left on if there is an open lines.

  24. City personal must have access to all City meters. For access, the following is required;

    Utility personnel must have access to locked gates. No shrubberies around or covering meters that will keep personnel from reading or servicing. Insure pets are kept under control and do not interfere with accessibility to the meter. If you require addition information contact our office.

  25. Leave This Blank:

  26. This field is not part of the form submission.