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Application For New Utility Service


    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 Activation Fee will be billed to 1st month's bill.

  4. Commercial Service Fees

    Commercial Water $80, Gas $100, Both $144 Activation Fee will be billed to 1st month's bill.

  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 need 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. Please select the date for service to start. This will be the date billing for service will begin.

  14. City of billing address

  15. State of billing address

  16. Zip code of billing address

  17. The date your where born.

  18. A valid email address.

  19. Place of employment.

  20. 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.

  21. Electronic Signature Agreement

    You are signing a legally binding Agreement; Your electronic signature is the legal equivalent of your manual signature on this Agreement as allowed by O.C.G.A. § 10-12-7; Your use of a key pad, mouse or other device to select an item, button, icon or similar act/action, constitutes your signature (hereafter referred to as “E-Signature”), acceptance and agreement as if actually signed by you in writing; You waive the right to verification of your E-Signature through any third-party and such waiver will not in any way diminish the legal effect and/or enforceability of your E-Signature; You agree that, knowingly and willfully making a false, fictitious, or fraudulent representation, and/or use of any false writing or document within the jurisdiction of state government, is a violation of the Georgia Computer System Protection Act (O.C.G.A. § 10-12-7, et seq.), as well as a felony under O.C.G.A. § 16-10-20.


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

  23. 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?

  24. 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.

  25. 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.

  26. Leave This Blank:

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