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2. Processing Time
   Please allow a minimum of 5 business days to process your request.
4. Today's Date*
   Today's Date
6. Applicant's Full Name*
8. Phone Number*
9. Email Address*
11. Owner / Renter*

    1. Owner
    2. Renter
13. Stop Service Address*
15. Forwarding Mailing Address*
    Final bill will be mailed here.
17. Closing Date*
    Closing Date
19. Final Meter Reading

    *this is required to calculate an accurate utility 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.

21. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that   1) your application will not be signed in the sense of a traditional paper document, 2) you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
23. Electronic Signature of One Name on Utility Account*
24. Date*
    Date
28. New Owner / Occupant Name(s) (If Known)
30. Phone Number
31. Email Address
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field