Service Address * Start Date (escrow closing) * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 Should be legal escrow closing date. If there is a discrepancy staff may need to contact you. Owner Name (First) * Owner Name (Last) * Additional Contact Name Billing Address (if different) Owner is responsible to update billing address with the District. If there is Change of Address on file with USPS, your account will be updated. Phone Number * E-mail * Electronic Acknowledgement * By checking this box, the applicant requests the San Lorenzo Valley Water District to furnish water service to the premises noted above and agrees to pay the rates in effect applicable for the services rendered; and agrees to abide by the rules and regulations affecting said service. Property owners are responsible for all water bills. The undersigned hereby acknowledges that she/he is a legal property owner of record for the subject parcel. The District assumes no responsibility for contact information that has not been kept up-to-date by the customer. It is the owner's responsibility to alert the District to any changes in address or mailings in care of another name. A Change in Billing Information form must be filled out. A $20 new account fee will be charged to establish service, this will be on the next bill. Electronic Acknowledgement Leave this field blank
