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2. Service Start Dates

   Service start dates are only available Monday-Thursday & alternating Fridays (Excluding Holidays)

   Please see the District Calendar 

   for Friday closure schedule.

3. Start Service Date:*
   Start Service Date:
4. Service Type:*

   1. Residential
   2. Commercial
   3. Fire Protection
5. Applicant Status:*

   1. Owner
   2. Tenant
   3. Property Manager
7. Please note: application will not be processed until the required fee & deposit have been collected. A representative will contact you within one business day of application submission.
9. Service Address:*
11. City*
12. State*
13. Zip Code*
15. Type of ID:*

    1. DMV Issued ID
    2. Passport
    3. Other
16. please upload copy of ID:*
17. additional documents:

    i.e. Close of Escrow Statement, Rental Agreement

19. Name or Business Name*
20. Email Address:*
22. Mailing Address:*
24. City*
25. State*
26. Zip Code*
28. phone Number:*
29. Cell Phone:*
31. Water Utility Service - Terms and Agreement

    a. Utility Service Application Fee - $65.00 non-refundable fee charged per account for requesting to establish residential, commercial, and/or fire protection utility services; accounts are established based on the number of meters serving the residence or business 

    b. Service Deposit - Refundable amount required if the applicant does not have an established payment history with Valley County Water District at the time of requesting residential, commercial, and/or fire protection utility services; the service deposit is based on the type of utility service and the meter size serving the residence or business; all collected service deposits will remain on the utility service account for a minimum of one year, until the utility service account achieves an acceptable payment history, or until the utility service account is closed and finalized, whichever occurs first; service deposits will be refunded as a credit to the account and applied against any services rendered; service deposits applied in excess of services rendered will be refunded in the form of a check payable to the applicant listed on the utility service account; amounts due in excess of the service deposit will be mailed to the applicant listed on the utility service account for payment 

    c. Documentation - When establishing a utility service account, the applicant may be required to present a settlement agreement, or other documentation, showing the date they took ownership of the property or a rental agreement, or other documentation, showing the date they agreed to start renting the property; outstanding balances will be prorated on the first billing cycle based on the documentation provided

    d. Processing & Payment - After this application has been processed a Customer Service Representative will contact you via the phone number provided on this form to collect payment for the Utility Service Application Fee and Service Deposit. Utility Service Application will not be processed until these fees have been collected.

33. 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.

    1. I agree.
35. Electronic Signature*
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field