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2. City of Carver

   Complete this form to start utility services in the City of Carver. Utility services include water and sewer services.If you have questions regarding this form, please contact Brenda Efta, Utility Billing Clerk, at 952-448-8729.

4. Today's Date*
   Today's Date
6. Account Holder's Full Name*
8. 2nd Account Holder's Name (Optional)
10. Phone Number*
11. Email Address (Optional)
    By submitting an e-mail address, the City can notify you quickly in case or emergencies or problems at your home or in your neighborhood.
13. Owner / Renter*

    1. Owner
    2. Renter
15. Service Address in City of Carver Limits (55315)*
17. Mailing Address for Bill (only if different that service address)
19. Closing Date*
    Closing Date
21. Current Meter Reading:

    *this is required to start utility service and calculate an accurate bill

    If you are unable to read your meter at the time you submit this form, please return to our website and provide your final meter reading when available OR call it into City Hall at 952-448-8729.

23. Electronic Signature Agreement*

    I/We affirm that all information on this application is true and correct. I/We will assume the full responsibility of all financial obligations at the above service address until I/We have notified the City in writing to discontinue service. I/We have been informed that in the event of a non-payment for any of the above-referenced utility services, the City of Carver may assess said unpaid charges, penalties, and fees against the real property so served pursuant to Carver Code or Ordinance, Chapter 2. The City of Carver shall assess said unpaid charges by certifying the amount to the Carver County Auditor for collection as a real property tax. I hereby promise to pay all bills for service when due, and understand there is a monthly late payment charge on all unpaid balances.

    1. I agree.
25. Electronic Signature of One Name on Utility's Account*
26. Date*
    Date
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field