Start Residential Service |

**Days available are Monday – Friday, excluding holidays.

Is this a Joint Application or Individual Application?*

What date would you like to start your service?*

Turn on service at*

Street Number Street Name City State ZIP Code

Email*

Would you prefer an e-bill instead?*

Yes
No

Do you have a different mailing address?*

Yes
No

Mailing Address*

Street Address City State ZIP Code

Primary Account Holder

Name*

First Middle Initial Last

What type of Identification*

Identification*

Accepted file types: jpg, jpeg, png, pdf, doc, Max. file size: 2 MB.

Allowed file extensions: jpg, jpeg, png, pdf, doc / Maximum File Size: 2MB

Enter Identification Number*

Date of Birth*

Social Security Number*

Are you purchasing or renting?*

A copy of your deed will be required*

Accepted file types: jpg, jpeg, png, pdf, doc, Max. file size: 16 MB.

Allowed file extensions: jpg, jpeg, png, pdf, doc / Maximum File Size: 2MB

A copy of your lease will be required*

Accepted file types: jpg, jpeg, png, pdf, doc, Max. file size: 16 MB.

Allowed file extensions: jpg, jpeg, png, pdf, doc / Maximum File Size: 2MB

Have you previously had service with Alabaster Water?*

Phone*

Secondary Account Holder

Name*

First Middle Initial Last

What type of Identification*

Identification*

Accepted file types: jpg, jpeg, png, pdf, doc, Max. file size: 2 MB.

Allowed file extensions: jpg, jpeg, png, pdf, doc / Maximum File Size: 2MB

Enter Identification Number*

Date of Birth*

Social Security Number*

Have you previously had service with Alabaster Water?*

Your Email Address*

Phone*

Signature & Terms

You have requested service to start mm/dd/yy .

Terms and Conditions*

I Agree to the Terms and Conditions
I, we, the undersigned and above named applicant hereby request to be supplied with water by the undersigned Alabaster Water Board of the City of Alabaster, Alabama, for the purpose shown herein and none other. I, we, agree to pay for the service at regular scheduled rates applicable from time to time as set by the Alabaster Water Board now or at any future time and to comply with the rules and regulations of the Alabaster Water Board of the City of Alabaster, Alabama. I, we, further agree that:
1. The Alabaster Water Board shall retain title to all meters and other property furnished by it; and
2. I, we, shall be responsible for the safekeeping of all property of the Water Board placed on premises where I, we, receive service; and
3. I, we, shall guarantee free right of ingress and egress by the Water Board employees to meters and other property of the Water Board located on the said premises without obstructions (i.e., shrubs, decks, porches, parked vehicles, restrained animals, fences, etc); and
4. I, we, will keep in good repair all appliances and piping on said premises (other than meters maintained by the Water Board), first notifying the Water Board prior to having repairs made, and will report immediately to the Water Board any leaks discovered; and
5. I, we, shall not adjoin a supplementary water service to a new or existing water meter on the Alabaster Water Board's system; and
6. The Alabaster Water Board or the City of Alabaster shall not be liable for damages because of interruption of the supply of water or by reason of fires, accidents or any other cause due to or alleged to be due to the installation of service, and I, we, agree to indemnify the Alabaster Water Board against liability, loss or damage by reason thereof; and I, we, further agree to notify the Alabaster Water Board in writing one week (7 days) prior to vacating said premises or discontinuance of service for any reason; and
7. The Alabaster Water Board shall not refund any payments made by the applicant or property owner, for service pipe from the property line to the meter, unless covered by separate agreement; and
8. A late penalty of 10% of the current water, sewer, and garbage fees will be added on the delinquent date printed on the utility bill.
9. A deposit may be required before service is provided. The deposit will be applied to any unpaid charges when service is terminated and any remaining balance will be returned to the customer of record. Deposits will not earn interest.
10. A non-refundable connection fee will be charged.
11. Discontinuance of service or referably Cut Off Procedures, will be as follows:
a. Any amount past due in excess of $25.00 shall be subject to being cut-off/disconnected;
b. Cut offs and reconnections will be performed Monday through Friday during business hours of each week and reconnections only on Saturday between the hours of 10:00 am and 2:00 pm; and
c. A delinquent processing fee will be charged;
d. The account must be paid in full plus the processing fee before service will be reinstated; and
e. If for any reason a reconnection occurs after hours, there will be an additional call out fee.
12. The undersigned agrees to be liable for, pay, or reimburse the Alabaster Water Board for all costs and expenses, including, but not limited to, reasonable attorney's fees, annual percentage rate of 18% interest, incurred by the Alabaster Water Board in collecting or attempting to collect any sum due by the undersigned to the Alabaster Water Board for water and/or otherwise; and I waive all my rights of exemption as to personal property under the constitution and laws of the state of Alabama or any other state; and
13. The Alabaster Water Board shall have the right to discontinue service without further notice in case of the applicant’s failure to comply with this agreement or any part thereof, I, we, agree that any unpaid balance(s) on established account for services rendered, will be paid promptly at time service is discontinued.

PRIMARY APPLICANT's SIGNATURE - By submitting the information above, you agree that you are requesting to begin water service, and by typing your name below this will serve as your electronic signature.*

SECONDARY APPLICANT's SIGNATURE - By submitting the information above, you agree that you are requesting to begin water service, and by typing your name below this will serve as your electronic signature.*

Name

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