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2. This form is for property sellers only to request a special move-in or move-out water utility meter read.
4. Property Information
6. Owner Name(s)*
8. Service Address
10. Type*
    -- Select One --CommercialMulti-Unit ApartmentSingle Family Home
12. House, Building or Apartment Number*
13. Direction
15. City / State / Zip*
17. Note this submission will be timestamped when it is submitted. Water readings that are back-dated will be rejected
19. Date of Reading*
    Date of Reading
21. Final Billing Mailing Address
23. Name*
24. Address*
26. City*
27. State*
28. Zip*
30. Contact Information
32. Requester Name*
33. Email*
    Valid email required.
35. Phone*
36. Name of Title Company
38. Additional Comments
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field