Commercial Water/Sewer Application

* Indicates required field

Applicant Name *

First

Last

Business Name *

Phone Number *

Cell Number *

Work Number *

Driver's Licenses *

State *

Social Security Number *

Email *

Date of Birth *

What is the date you would like to start your service?
(Service can only be started on Working business days and cannot be any sooner then the next business day.)

Date Requested to Start Service *

Service Address *

City *

Zip Code *

Mailing Address (if different from above) *

Line 1

Line 2

City

State

Zip Code

Country

Do you Own or Rent this Business? *

Own Rent Rent to Own

If Rent or Rent to Own what is the name of Landlord *

Landlord's Phone Number *

How would you like to receive your bill?

I would perfer *

Printed Copy (You will receive your bill in the Mail) E Billed (Please double check your email address above) Both Printed and E Billed

From time to time we will need get in touch with you to let you know that your water is being shut off either due to non payment or due to Public Works working in your area.

I would prefer *

A Robo Call (this is an automated call) A Text Message

By clicking Submit, you agree to abide by all rules and polices established by the City of Willard, MO. (Available for review at City Hall). You also agree that you will NOT turn on or turn off your water meter or allow anybody else (including but not limited to professionals) for any reason.

Submit

We will NEED a digital COLOR copy of the Identification (Driver's License or other legal ID) for ALL person(s) who want to be on the account before we can complete the application.

Email the above Identification (most people are taking a picture of their ID) to the following emails (Please send to Both)