Application for Service -- Residential

Complete the form below to sign up for service or click here for the printable application

Customer Name: *

Date of Application: *

Service Starting Date: *

Own: *

Own

Rent

Service Address

Service Address: *

City: *

State: *

Zip: *

Mailing Address (If different from service address)

Mailing Address:

City:

State:

Zip:

Phone: *

Cell:

Fax:

Driver's License #: *

DOB:

Email:

Social Security #:

Number of residents at address:

Est. Water Consumption (GPM):

If renting, provide the following Landlord information

Name of Landlord/Contractor:

Phone #:

Address:

City/State/Zip:

Agreement

A Non-refundable start-up-fee of $25.00 (if meter reading only required) or $60.00 (if meter installation required) will be applied to first bill. Depending on the service address, you may receive a bill for sewage treatment from either the Forest Hills Municipal Authority (495-5614) or Johnstown Regional Sewage (533-2016). Windber Area Authority (467-5574) treatment fees are included on HSWA bill.

Usage of the Authority’s water or sewer service subjects the applicant to the Authority’s Rules and Regulations and current rates and fees.

Click to View: Water Rules & Regulations
Click to View: Sewer Rules & Regulations

I agree: *

I Agree

By checking this box, I agree and affirm that all the information entered on this form is correct and complete to the best of my knowledge and that I have read the Water and Sewer Rules and Regulations and agree to those terms and conditions.

Highland Sewer and Water Authority

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