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Pine Grove Community Services District – APPLICATION FOR WATER SERVICE

ALTERNATE CONTACT INFO

Enter the relationship with the property owner. If you are the property owner, enter “Self”.

Pet Information

I agree to the terms and conditions of the Rules and Regulations/Water Code of the Pine Grove Community Water Services District. A copy of the Rules and Regulations are available at the Rules & Regulations Page. If you are selling your property or have a renter moving, please contact us in advance for a final meter read and final billing. I understand that my signature below acknowledges my responsibility for all payments and charges applicable to the applied service(s) in accordance with the Pine Grove community Service District Rules and Regulations and serves as a signature of this document.
Please note – payment for rentals are the responsibility of the Owner.
Please type your full name to accept the terms.
Water Company Use: Meter Connection # ______________ APN:________________________________ Billing Acct# _________________ Date Received:__________________
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