FORMS

Application for Water and Sanitary Sewer Service

DOUGLASVILLE-DOUGLAS COUNTY WATER AND SEWER AUTHORITY

APPLICATION FORM FOR WATER AND SANITARY SEWER SERVICE

APPLICANT INFORMATION

Name

Date of Birth

Social Security Number

Driving License No.

Phone

Applicant is

Service Requested Date

Service Address

Address Line 1

City

State

Zip Code

Is the Mailing Address different than the Service Address?

AGREEMENT FOR WATER AND/OR SANITARY SEWER SERVICE

File(s) Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

Acceptable documents: 1 valid state or federal photo identification, and proof of occupancy or ownership (i.e., a signed lease/rental agreement, purchase agreement, or other documentation as determined acceptable by the Authority)

Signature

Clear Signature

Today's Date

Bank SERVICE Water

CREDIT/DEBIT CARD OR ELECTRONIC CHECK AUTHORIZATION

Method of Payment:

DEPOSIT AMOUNTS AND POLICY

For residential customers, the deposit is based on the services the home receives from the Authority:

Homes with water only (on septic tank) – Deposit between $50.00 and $125.00, depending on meter size
Homes with both water and sewer – Deposit between $125.00 and $275.00, depending on meter size

A $25.00 application fee will be assessed to the first bill for each new account established. For commercial, industrial, and other non-residential accounts, please contact Authority Customer Service for accurate deposit amounts and for deposit information.