Service Application

THIS FORM IS FOR PROPERTY OWNERS ONLY. All tenants must have their landlord or management company contact the office to add their name to the account. All service applications must be submitted with a copy of applicants drivers license. This form cannot be submitted unless a copy of your drivers license has been uploaded at the bottom of the page.

*If fire suppression is selected, a fire suppression release must be completed and emailed to*

Applicant Information
Service Address
Billing Address
Emergency Contact Information
Owner Information

I hereby apply to the Borough of Sewickley Water Authority for water service at service address listed above.

I, The owner/tenant of/at the property listed above, agree to abide by the rules and regulations that are now in effect, or which will be adopted in the future by the Borough of Sewickley Water Authority.

I understand that a 10% penalty will be assessed on the unpaid current balance after the due date. I also understand that failure to pay my water bill for a period of 30 days past the due date will cause the water service to be terminated. Should service be terminated, a service charge of $20 will be added to the account to restore service privileges.

I understand that I am responsible for the water meter and any damage done to the water meter by freezing, tampering, or breaking of the seal. I agree to pay for any damage done to the meter.

I represent that the above location is presently capable of accepting water service. I understand this application is accepted subject to availability of water at this location.

Files must be less than 4 MB.
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