Application for Water and/or Sewer Service

Please note: This completed application, a copy of your photo ID, copy of a HUD Settlement Statement or Warranty Deed of buyer and seller are all required documents to complete the application process.

APPLICANT NAME *

PHOTO ID #/STATE *

TELEPHONE NUMBER *

EMAIL ADDRESS *

SERVICE ADDRESS *

ACTIVATION DATE *

BILLING NAME

BILLING ADDRESS (IF DIFFERENT FROM SERVICE ADDRESS)

CITY

STATE

ZIP CODE

SEWER AND/OR WATER SERVICE CONTRACT

Applicant for water and/or sewer service agrees, if applicable, to conform to and abide by all the rates, rules and regulations provided by ordinance, code, resolution or otherwise of the City of Bradenton for water, wastewater and/or garbage services as are now or hereafter, in force and which are a part of this contract. It is the responsibility of the applicant to provide notice, through the Utilities Department, when service is to be discontinued. This completed application, a copy of your photo ID, copy of a HUD Settlement Statement or Warranty Deed of buyer and seller are all required documents. Deposits and service fees are required before service is rendered. For standard residential accounts, this is a $15 service fee and a $135 water account deposit. Once account is established, applicant will receive account detail information and payment instructions.

* - denotes required field