Service Application

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

Tenant

Effective Date For Service (required)

Month

Day

Year

Applicant Information

Applicant Name: (required)

Spouse Name:

Contact Name:

Service Address

Address: (required)

City: (required)

State: (required)

Zip Code: (required)

Billing address same as service address

Billing Address

Contact: (required)

Address: (required)

City: (required)

State: (required)

Zip Code: (required)

Are you a previous SWA customer? (required)

Yes

Previous service address:

Emergency Contact Information

Main Phone #: (required)

Cell Phone #: (required)

Email: (required)

Owner Information

Owner Name: (required)

Address: (required)

City: (required)

State: (required)

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 $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.

Sign Below to signify you accept the terms of service above.

Drivers License Upload (required)

Files must be less than 4 MB.
Allowed file types: gif jpg jpeg png bmp eps tif pict psd txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml avi mov mp3 ogg wav bz2 dmg gz jar rar sit tar zip.

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Service Application