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Start Residential New Service Application
Requested Start Date
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Are you a
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Property Owner
Renter
Property Manager/Realtor
Primary Applicant's First Name
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Last Name
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Date of Birth
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Last Four of Social Security Number/ Tax ID Number
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Valid Driver's License Number
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Service Address
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City
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State
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Alabama
Alaska
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California
Colorado
Connecticut
Delaware
Florida
Georgia
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Idaho
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Oregon
Pennsylvania
Rhode Island
South Carolina
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Tennessee
Texas
Utah
Vermont
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Washington
West Virginia
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Washington DC
Zip Code
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Phone Number
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Email Address
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Do you wish to receive your bill through e-mail?
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Yes
No
Billing Address
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City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
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Check all that apply.
Pool
Sprinkler System
Water Softener
How many people will be living in the residence?
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Secondary Applicant Information
Secondary Customer Name
Last Name
Date of Birth
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Last Four of Social Security Number/ Tax ID Number
Valid Driver's License Number
Phone Number
Email Address
Emergency Contact
First Name
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Last Name
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Phone Number
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Email Address
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Renter Only Section
Landlord/Owner Name
Last Name
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
Phone Number
Email Address
Terms & Conditions
Chapter 22 Article VI. Sec 22-280 Cross Connection Control Program
Backflow Devises: The City of League City is responsible for protecting the drinking water supply from contamination or pollution which could result from improper private water distribution system construction or configuration. This serves as a notice to the customer of the restrictions in place to provide this protection. The City of League City enforces these restrictions to ensure the public health and welfare. Your acceptance of water services acknowledges that the City will do annual backflow inspections to any new or existing devices. If the customer fails to comply with the terms of the backflow requirements, the City of League City will either terminate service, properly install, test and/or maintain an appropriate backflow prevention device at the service connection. Any expenses associated with the enforcement shall be billed to the customer. ***For more information on the Backflow devices, refer to Chapter 22 Article VI. Section 22-280
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Same Day Service or After Hours Service:
I understand that I may incur a fee if I am requesting for my services to be connected same day or after business hours. This fee will be present on my initial statement along with my deposit and connection fee.
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Connection to Water:
I understand that the City will begin water service by making a physical connection from the meter to the outside of the residence. I understand that the City will not have access to personal property and will not determine if there are any open faucets or water system leaks on or in the property.
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City of League City Sec. 114-121 Disconnection of Service for Nonpayment
I understand that I am responsible for paying my monthly bill on or before the due date. Under City of League City ordinance, If any water, wastewater, or solid waste charges are not paid within ten business days after the due date, such service may be discontinued.
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Pursuant to Sec. 182.052. Confidentiality of Personal Information:
A government-operated utility may not disclose personal information in a customer's account record, or any information relating to the volume or units of utility usage or the amounts billed to or collected from the individual for utility usage, if the customer requests that the government-operated utility keep the information confidential. You may exercise your right for confidentiality by initialing below.
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Red Flag Policy and Identity Theft
To attempt to prevent identity theft, The City of League City requires all applicants to provide a government issued picture ID, the last four digits of your social security or tax ID number, or similar documentation to establish utility services. Please note that additional documentation may be requested.
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Copy of Primary Driver's License or Valid Government Issued ID
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Closing Disclosure, Settlement Page, or Rental Agreement
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Copy of Associated Customer's Driver's License or Valid Government Issued ID