New Customer - Existing Home Utility Application

The information below should be filled out as completely and fully as possible.

A one-time customer application fee of $20 will be billed to your account upon application approval.

An email confirmation will be sent to you once the application has been submitted at the email address provided.

Customer Information

Applicant First Name *

Applicant Last Name *

Spouse's Name (if applicable)

Service Address *

Service Address Line 2

City *

State *

Zip Code *

Billing Address (if different from Service Address)

Billing Address Line 2

City

State

Zip Code

Cell Phone Number *

Home Phone Number

Email Address *

Driver's License # *

Spouse's Driver's License #

Date of Birth *

Spouse's Date of Birth

Employer *

Employer Phone Number *

Spouse's Employer

Spouse's Employer Phone Number

Closing Date +

Settlement Statement Upload (Required if buying. Must have to activate account.)

Emergency Contact

In case a water emergency occurs, please list someone who should be contacted.

Contact Name *

Contact Phone *

Utility Service Agreement

I, hereby apply to receive Water and Garbage collection services from the Riverton City Utilities Department.
I, the customer, agree to permit Riverton City, its agents or employees to enter the described premises at all reasonable time for the purposes necessary to render such service.
Customer agrees to pay all utility bills on or before the 25th of the month. It is understood that if the utility bill becomes 60 days delinquent, the service will be turned off. In order for service to be restored, a reconnection fee will be charged, and all delinquent amounts must be paid in full. NOTE: if your service is shut off do not turn it back on, contact Riverton City Water Department to avoid the issuance of a citation for tampering with City property.
Customer agrees to pay a late fee per month on any delinquent account.
As the property owner I understand that I am responsible for all my charges past, current and future as long as this account is listed in my name.
Customer agrees that they will make certain that the meters and equipment are readily accessible to City personnel, and there are no barriers or animals, which would prevent reasonable access.
The Water meter is property of Riverton City. If you need the water turned on or off for any reason, please contact this office. Any damage within the meter barrel or to the electronic pads and equipment associated with the water meter will be assessed to the property owner.
Customer agrees to notify Riverton City of termination of service at least 48 hours prior to vacating the service address.
In the event payment under this agreement is not made at the time and in the manner required, the undersigned agrees to pay all costs of collections, including attorney fees, court costs, filing fees, including charges and collections fees of $100.00 or ½ balance assigned, whichever is less with or without suit. I, agree that in the event of default in the payment of any amount due, and if this account is placed in the hands of a collection agency or attorney for collection or legal action, to pay an additional charge equal to the cost of collection, including collection agency fees, attorney fees and court costs incurred with or without suit and permitted by laws governing these transactions. If your account is turned over to a collection agency a collection fee of 35% to 50% of your existing balance due, not to exceed more than $500.00 may be added to your account balance. (A finance charge 3% simple interest will be charged on all business over 90 days). There is a $20.00 returned check fee on all returned checks and additional amounts as allowed by Utah Code 07-15-1. You are responsible for any balance due within twenty-five days after service.
Riverton City reserves the right to communicate with utility customers via mail, email, phone, or text for any reason.

Customer Signature: *

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Today's Date: * +