Residential - Application for New Service
(Submit separate form for each address)
Submitted by
Date
Bus. Phone
Fax
Email
Applicant Information
Name
Address
City and State
Zip
New Service Information
Address
City
Zip
SVC
Meter
Lot
Block
Subdivision
Legal Description - If not platted subdivision, fax full meets and bounds legal description to 913-895-1827.
Plummer's Name
Mailing Address
City and State
Zip
Business Phone
Fax
Email
Comments
