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Application for Utility Services

  1. Application for Utility Services
  2. Deposit:
    Sewer/Trash - $65.00 Water/Sewer/Trash - $115.00 ($25.00 Water turn on fee/ $90 deposit) Trash Only - $25.00 Sewer Only - $65.00 Commercial Accts - $250.00
  3. Services Applying For: *
  4. Service Address
  5. Mailing Address
    (If different than service address)
  6. Senior Citizen Discount
    There is a 10% discount on sanitation services for seniors 65 and older. Please supply the utility department with a copy of your state issued identification to qualify.
  7. Note:
    Payments are due by the 10th of each month. Deposits will be returned after 12 consecutive months of on time payments. Returned checks / NSF electronic draft will be subject to a $25.00 fee.
  8. Sewer Customers with Goforth Water
    If you receive your water bill from Goforth Water Supply Company, you can submit your water bills for the months of November, December, January & February to us each year to calculate your sewer bill for the next year. If you do not submit those bills you will be charged based on 7,000 gallons of water usage to calculate your sewer.
  9. Garbage Service (check all that apply)*
  10. Terms of Acceptance*
  11. Services
  12. Leave This Blank:

  13. This field is not part of the form submission.