New Residential Garbage Only Service Application

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Please correct the field(s) marked in red below:

Applications received by 4 p.m., Monday through Friday, will have water service started the next business day by 5:30 p.m. Applications received after 4 p.m., or on Friday, will have service started within two business days by 5:30 p.m.
The following information you are submitting is secured through browsers that have 128-bit encryption enabled. For problems or inquiries please contact 281.652.1603

1
Date to Start Service
 *
2
Customer Name   (Primary person listed on settlement page or lease agreement)
 *
3
Service Address
 *
4
Mailing Address
 *
5
Phone/Cell Number
6
Email
 *
7
Employer
Employer
8
Your Information
Your Information
This information is all regarding your spouse/other.
9
Spouse Information
 *
Spouse Information
10
Spouse/Other Employer
 *
Spouse/Other Employer
11
Spouse Information
Spouse Information
12
Emergency Contact
Emergency Contact
13
Landlord Information (If Applicable)
Landlord Information (If Applicable)
14
Do you want your utility bill sent by email?
Do you want your utility bill sent by email?
15
Do you want your address, telephone number and Social Security number kept confidential?
Do you want your address, telephone number and Social Security number kept confidential?
16
What email address would you like your utility bill sent to?
 *
17
Failure to provide all of the Federal Regulations within 10 days will result in termination of services and additional fees will incur and must be paid before services are resumed.
Failure to provide all of the Federal Regulations within 10 days will result in termination of services and additional fees will incur and must be paid before services are resumed.
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