RECEIPT NO ________________
                                                 ACCT NO ___________________
                                                 DATE ______________________

 

APPLICATION FOR COMMERCIAL WATER SERVICES
BUSINESS NAME ______________________________________________________________
SERVICE ADDRESS ____________________________ MAILING ADDRESS _______________

____________________________________________________________________________

TYPE OF BUSINESS _________________________________ PHONE NO ________________
MANAGER'S NAME ___________________________________ PHONE NO ________________

 

IN ORDER FOR WATER TO BE TURNED ON, ALL FAUCETS, ETC., MUST BE OFF.
THE SERVICE PERSONNEL ARE NOT ALLOWED TO GO INSIDE THE BUILDING.
DATE OF SERVICE ____________________
                                      SIGNATURE ___________________________

 

OFFICE USE ONLY
DL# _____________________
SS# _____________________
DOB _____________________

 

City of Roswell     Post Office Box 1838     Roswell, New Mexico 88202-1838
             (505) 624-6711          (505) 624-6709 - Facsimile