Application of Utility Services - City of Alamo Heights

Service Address*

Name*

First Middle Last

Company Name (if applicable)

Mailing Address (If different from service address))

Phone*

Cell

Work

Drivers License State*

Drivers License Number*

Date of Birth*

Email*

Are You:*

Landlord Name*

Landlord Phone Number*

As of what date would you like the service established in your name?

Have you had service in Alamo Heights?*

Under what name(s) and at what address(es)?*

I have agreed to submit this application by electronic means. By signing this application electronically, I hereby request the City of Alamo Heights to furnish water, sewer, and sanitation services at the above service address, and I agree to pay for such services at the rates set by the City Council. New residential sewer rate is based on the annual City average, until a sewer rate is established during the winter averaging period (Nov., Dec., and Jan.) The bill for such services is due and payable as indicated on each month’s bill. I understand that if I fail to pay for services, the City may disconnect my service without notice until arrears are paid in full. A reconnect fee will be charged and must be paid in full at the time of reconnect. I agree to abide by and consider as part of this contract and ordinance, rules and/or regulations set by the City concerning the operation and billing of all services. I authorize the City of Alamo Heights to disconnect water service if violations of zoning, building, subdivision, animal, fire, food, trash, week and sign ordinances of the City of Alamo Heights occur at the service address above. I do hereby certify that the information given above is true and correct.

I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.

Step 1. Check the Box Below*

By checking this box and typing my name below, I am electronically signing my application.

Step 2. Type in Your Name*

First Middle Last Suffix

Phone

This field is for validation purposes and should be left unchanged.