Transfer of Account Holder Service Address: (required) Service to Begin On: (required) Legal Owner: (required) I am the legal owner I am the tenant Billing Name: (required) Billing Address: (required) Phone: (required) Secondary Phone: Email Address: Property Type: (required) Residential Vacation Rental Long Term Rental Commercial Check all boxes below to acknowledge - As an applicant for service I acknowledge and accept the following responsibilities: (required) The meter and shut off valve are the property of PCJWSA and tampering with either item is prohibited. All pipes, valves, and connections from the owners side of the meter to the business or dwelling is the sole responsibility of the property owner. All utility bills are due the 15th of each month. There is a charge of $25.00 for returned checks. Check all boxes below to acknowledge even if not applicable - Tenants only: (required) There is a $300 service deposit for all long term rentals that will be collected once the account is created. This deposit will be refunded to the account holder when service ends. PCJWSA requires a copy of the rental agreement between the owner and tenant. Upload Rental Agreement if applicable: I understand that I am responsible for payment of monthly water and sewer user fees and any other usual rates and charges assessed against the Account Holder by the PCJWSA. Authorized Signature: (required) Today's Date (required) There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
