Application for Water Service

Customer Information:

Spouse / 2nd Responsible Party

Billing / Previous Address

Only fill out the following section if you rent this location:
The undersigned warrants that the information on this application is true, and provided without intentional omission.
Important: Reedsburg Utility requires positive identification and/or a service deposit as allowed by the Wisconsin Public Service Commission. Before service can be furnished, this application must be completed in full and submitted to Reedsburg Utility Commission. Missing and incomplete information will delay service. A copy of the building permit must be provided as well as payment of applicable fees prior to service connection.

Service Information

Important: Before water service is furnished, this form must be completed and returned to Reedsburg Utility Commission, along with a copy of a Building Permit, and payment for the appropriate Impact Fee. This is not a tapping or service fee. It is an impact fee based upon meter size. If the meter sizes needs to be changed, an impact fee will be charged for the difference in meter size.

Plumbing Statement / Information

The Plumber states that all plumbing performed under this permit at this service location is in compliance with the State Plumbing Code of Wisconsin. The Plumber further represents that all meter settings have been properly marked and identified in situations involving multiple meters.