Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

APPLICATION FOR UTILITIES SERVICE

  1. COH logo overlay

  2. All contracts for municipal utility service shall be signed in the true name of the customer(s) actually to receive and use such service. Any changes in the identity of the contracting customer at premises shall require a new application. The City may discontinue any municipal utility service until the City has accepted such new applications. Ordinance No. 2692 Sec. 700.080 Utility Service Application required.

  3. APPLICANT(S):

  4. ALL ADULTS LIVING AT THE SERVICE ADDRESS MUST BE INCLUDED ON THIS APPLICATION.

  5. ALL ADULTS LIVING AT THE SERVICE ADDRESS MUST BE INCLUDED ON THIS APPLICATION.

  6. FOR SERVICE AT:

  7. Do you have access to a printer?*

    Check yes or no

  8. BILLING ADDRESS IF DIFFERENT FROM ABOVE:

  9. EMERGENCY CONTACT INFORMATION (Not someone living at the service address)

  10. Leave This Blank:

  11. This field is not part of the form submission.