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2. Fees

   There is a $110 water deposit required for renters. If the water in the residence is currently on, there is an additional $15 meter reading fee. If the water is currently off, there is a $50 water connection fee.  Services require one business day to be connected. Applications summited on Friday will be completed on Monday.  Please call or come in to the Kanab City Office to pay.

4. Service Address*
   Indicate address location using (East-West/North-South) street address.
6. First Name*
7. Last Name*
9. Mailing Address*
10. Phone*
12. City*
13. State*
14. Zip*
16. Applicant SSN*
17. Birthday*
    (mm-dd-yyyy)
19. Driver's License #*
20. State*
21. Expiration*
23. Employer Information
    Name, Address, Phone
25. Spouse First Name
26. Spouse Last Name
28. Spouse SSN
29. Birthday
    (mm-dd-yyyy)
31. Driver's License #
32. State
33. Expiration
35. Spouse Employer Information
    Name, Address, Phone
37. Please indicate if you are renting or if you own the home.*
    -- Select One --RentingOwn
39. If Renting, Please Indicate Name, Address and Phone Number of Landlord:
41. References*
    Provide name, address, and phone number for at least two references.
43. Trash Services
    -- Select One --NOYES

    Note: Select YES if this is a new home and a trash can has not been delivered or if an additional trash can is needed. Select NO if the property already has a trash can or an additional trash can is not needed. A $75 charge will be applied to your bill and an additional $10 monthly service charge will be applied. Trash Cans remain with the property.
45. Connect Date for Service*
    Connect Date for Service
46. Has the water been turned off at this location?*
    Yes/No
48. Email*
49. Date*
    Date
51. Customer Agreement (Type Name)*
    The applicant agrees to pay monthly for the utility service rendered by the City of Kanab. Charges for service will be made at the established rates for the class of service applicable to the applicant.
53. Agreement (Type Signature)*
    The undersigned herby applies for water service from the municipality of Kanab, Utah and herby agrees: 1. To pay charges for such water service as are fixed from time to time by the governing body until such time as I/we shall direct such service to be discontinued. 2. In the event of a failure to pay water charges within the due dates fixed by the governing body or a failure of the occupant of the premises to conform to the ordinances and regulations established by the governing body regulating the use of the water system, that the municipality shall have the right to discontinue the water system service at its election, pursuant to five days written notice of the municipality's intention mailed to the address of service, until all delinquencies and any re-connection fees imposed are paid in full or until any failure to conform to this ordinance or regulations issued thereunder is eliminated. 3. To be bound by the rules regulations, resolutions, or ordinances enacted or adopted by the governing body applicable to the municipality's water system. 4. Applicant will deposit the appropriate fees with the municipality on the filing of this application for water service, and it is agreed and understood that the municipality may, but need not, apply the deposit upon bills due for prior service and that right of the municipality to shut off service as above provided shall exist even though the deposit has not been applied to the payment of past due bills for services. On final settlement of applicant's account, any unused balance of the deposit will be refunded to applicant upon return of the security deposit receipt issued by the municipality at the time the deposit is made. 5. The deposit shall not be considered as an advance payment for any service. Charges and unpaid accounts shall be considered delinquent notwithstanding the existence of the deposit and the applicant or user of water service shall not have the right to compel the municipality to apply deposit to any account to avoid delinquency. 6. In the event of collection, I/we agree to pay all attorney's fees, court costs, filing fees, and all collection costs, up to 50% of amount owed, may be assessed by any collection agency retained to pursue the matter. I/we further agree to pay interest at the rate of 1 and 1/2% per month (18% per year).
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55. Submit

* indicates a required field