Name on Account:	*
Service Address:	*
City:	*
Zip:	*
Subdivision
	Mailing Address is the same as the Service Address
Mailing Address:	*
City:	*
State:	*
Zip:	*
Parcel ID Number:	* Search for your Parcel Number It is important to enter this accurately to verify you are a Seminole County Water & Sewer customer.
Daytime Phone:	*
Cell Phone:
E-Mail Address:
Driver's License State:	*
Driver's License Number:	*
Date Service to Begin:	*
Which will you be doing:	(Deposits cannot be made online. The county does not bill the deposit and it is to be paid at the time service is started.) Providing a Letter of Credit Making a Deposit
If a rental property, mark the services you agree to be responsible for:	(If unsure, please check with your landlord)   Water     Sewer    Irrigation
Do you have an irrigation system?	Yes     No
Do you have a Backflow Prevention Assembly (BFPA) on your irrigation system?	Yes     No     Not Sure
Do you have an auxiliary water supply? (well, lake, pond, reclaimed, other)?	Yes     No     Not Sure

***IMPORTANT DISCLAIMER - PLEASE READ***

Any account set up after 12:00pm that has been disconnected will not be scheduled to have water reconnected until the following business day.

Deposits will be refunded to your account after 12 consecutive months of on time payments. Deposits cannot be made online.

Letter of credit requirements: Must come from previous utility company (water, electric, or gas). Must cover last 12 months of service, no more than 3 late payments, no returned checks, no disconnects for non-payment. New customers should call prior to start of service to ensure receipt of the application and letter of credit or deposit.

There will be a $30.00 service charge on  your first bill to cover maintenance and administrative costs related to opening your account.

I am applying for utility service from Seminole County Water and Sewer Utility at the above address.  I agree to follow and abide by all rules for utility service and pay charges in effect as stated on each  monthly bill.

I am also responsible for making sure that all faucets are turned off in the home before the service is established.  The county is not liable for damages caused by water faucets or outlets left on.

I understand that non-payment of my account will result in discontinuation of service.

I have read and understand the information specified above. *