Start Service Form

Please fill out the form below to begin water service with Orchard Dale Water District.
A $30 non-refundable fee will be applied to your first bill. Additional Fees may be required.

Residential

Occupancy

Service Start Date

First Name

Last Name

Confirm Email

Drivers License

Drivers License State

SSN

Date of Birth

Address

City

State

ZIP

Phone

Employer

Employer Email

Employer Business Phone

Address

City

State

ZIP

Name

Address

City

State

ZIP

First Name

Last Name

Phone

Address

City

State

ZIP

Comments

I hereby apply for water service at the above address, and as the undersigned applicant, in consideration of being supplied with water service by the Orchard Dale Water District (“District”) at the above service address, agrees to pay for said services as bills are rendered by the District, at the then-current rates, until such services are discontinued. The undersigned applicant further agrees to abide by all rules and regulations of the District in effect and as may be adopted from time to time. The District is hereby authorized to enter and inspect the above land as necessary for metering, repairs, and maintenance. This agreement shall at all times be subject to changes or modifications by the District in the exercise of its sole discretion. Additionally, the undersigned applicant agrees to the following: 1.District retains title to all water meters. District responsibility ends at the customer side meter connector. District is not liable for any water use on the above property, including leaks. The property owner remains responsible for all bills owed to the District whether or not the property owner actually resides on the premises or signs this Application for Water Services. 2.District does not guarantee continuous delivery of water on demand, nor does it assume any responsibility for damages which may occur as a result of any interruption of water service. 3.District assumes no responsibility for pressure regulation of customer's water service. It is each customer's responsibility to install and maintain a pressure regulation device to safeguard their water system. 4.Delinquent accounts will be assessed a penalty and may be subject to disconnection of water service for non-payment. Additionally, the District reserves the right to place a lien on the property, pursue other collection measures, and charge any applicable fees related to recovering any unpaid balance. A $30 nonrefundable application fee will be applied to your first bill. Additional fees may be required. To review the water rates schedule, and rules and regulations, visit our District website.

Business

Occupancy

Service Start Date

Business Name

Federal ID

Confirm Email

Address

City

State