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Release for Reconnection of Water
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This form has been modified since it was saved. Please review all fields before submitting.
Water Service Information
I request the reconnection of water at the following address from the City of Rio Rancho (this is NOT a HUD, foreclosure, Repossessed Home, or Short Sale):
Service Address:
*
Address, City, State, Zip
Requested Turn on Date:
*
Requested Turn on Date:
For
*
Non - Payment
New Service
Applicant Information
Name:
*
Must be the accountholder
Phone:
Ordinances
Section - 51.09 Discontinuance, denying and restoration of service: The utility reserves the right to schedule restoration of utility service on the day following payment of balance due.
Acknowledgement and Signature
I release the City of Rio Rancho Water Department of any liability in connection with turning on water service to the above referenced property. Since no one will be present when the water is turned on, I will take full responsibility for any leaks or running faucets that may result in water damage, to the above mentioned property. I confirm that this service address is NOT a HUD, Foreclosure, Repossessed Home, or Short Sale.
Signature
*
Date
*
Date
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