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. Application Type: (required) Water Service ONLY Water/Sewer Service Fire Suppression *If fire suppression is selected, a fire suppression release must be completed and emailed to swater@sewickleywater.org* Service For: (required) Owner Effective Date For Service (required) Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20232024 Applicant Information Applicant Name: (required) Spouse Name: Contact Name: Service Address Address: (required) City: (required) State: (required) AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code: (required) Billing address same as service address Billing address same as service address Billing Address Contact: (required) Address: (required) City: (required) State: (required) AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code: (required) Are you a previous SWA customer? (required) Yes No Previous service address: Emergency Contact Information Main Phone #: (required) Cell Phone #: (required) E-mail (required) Owner Information Owner Name: (required) Address: (required) City: (required) State: (required) - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code: (required) Main Phone #: (required) Cell Phone #: Email: (required) 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 $30 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. Drivers License/Business Document Upload (required) Files must be less than 10 MB.Allowed file types: gif jpg jpeg png. Sign Below to signify you accept the terms of service above. Leave this field blank