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Application for Water and Sewage Service

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Application for Water and Sewage Service

Danville Municipal Water and Sanitation Utilities

49 N. Wayne St., Danville, IN 46122

317-745-4180 ext. 7004

1. Please Complete the form.

2. Submit two forms of I.D to the Utilities Department:

*Email: Utilities@danvilleIN.gov

* Fax: 317-745-3005

* Drop off: Clerk-Treasurer Office 49 N. Wayne St., Danville, IN 46122

3. $100 deposit is required for all renters.

* Denotes a required field

Please Do Not Complete The Following Field

Section 1: Application Information

Start of Service Date:*

Last Name*

First Name*

Property Address:

Country*

Address*

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Province / Region*

Postal Code*

Billing Address:

Country

Address

City

State

ZIP

Zip-Zip +4
Second portion of ZIP Code is optional.

Province / Region

Postal Code

Email Address*

Home Phone:*

Phone Area Code-Phone 3-Phone 4 ext Extension

Cell Phone:*

Phone Area Code-Phone 3-Phone 4 ext Extension

Work Phone:

Phone Area Code-Phone 3-Phone 4 ext Extension

Section 2. Legal Deeded Owner of Property Information

If you are NOT the legally deeded owner of the property then complete section 2. If you are the legally deeded owner of the property then sign section 3 under owner.

Last Name:

First Name:

Country

Address

City

State

ZIP

Zip-Zip +4
Second portion of ZIP Code is optional.

Province / Region

Postal Code

Home Phone:

Phone Area Code-Phone 3-Phone 4 ext Extension

Cell Phone:

Phone Area Code-Phone 3-Phone 4 ext Extension

Work Phone:

Phone Area Code-Phone 3-Phone 4 ext Extension

Section 3. Affirmation

I hereby state the above information is true and correct:*

True and Correct

Date:*

MonthDay Year,

Owner of Record:

Tenant entered into rental agreement with the Owner of Record:

Initial:*

ALL CUSTOMERS ARE SUBJECT TO A MINIMUM BILL NO MATTER THE LENGTH OF SERVICE OR THE AMOUNT OF USAGE ACCORDING TO TOWN ORDINANCES 27-2023, 28-2023 and 30-2023, Passed December 6, 2023. By initialing, you state that you have read and understood this information.

Upon submittal of the application, your water/sewer service shall be connected within 48 hours of processing within regular operating hours for the Department. No after-hours connection is authorized.

I'm not a robot*

Town of Danville, Indiana

The Town of Danville is a great place to live, work and do business.

Application for Water and Sewage Service

Section 1: Application Information

Section 2. Legal Deeded Owner of Property Information

Section 3. Affirmation

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