PLEASE complete all information clearly, incomplete applications cannot be processed.

This form is used to establish or end residential service billing at an existing water and sewer address only and NOT to be used with new construction.
Are you:*
Select all that apply:*

ADDRESS TO BEGIN SERVICE

Please verify if you are the current owner, landlord, or tenant:
Name
Service Address
Billing Address
If different from Service Address
MM slash DD slash YYYY

ADDRESS TO END SERVICE

Please verify if you are the current owner, landlord, or tenant:
Name
Service Address
Billing Address for Final Bill
If different from Service Address
MM slash DD slash YYYY
A final meter reading is required when requesting to end water service billing.
Customer will be subject to current rates, rules and regulations as set in our tariffs approved by the Public Service Commission of Wisconsin. You are responsible to notify the City of Fountain when you vacate to end billing at the property. You are liable for all charges incurred until the end date of services. You are also required to provide the City of Fountain with any changes to contact information.