City of Columbia Water Service Application

City Of Columbia Application for Water Service Contract

Customer Care Division, P.O. Box 147, Columbia, S.C. 29217 PHONE: (803) 545-3300 | FAX:(803) 733-8219
Please allow two business days from submission of contract for the processing of your request. In some cases, we may need to contact you for additional information before processing your request. A red asterisk (*) indicates a required entry.
START WATER SERVICE (New service–no existing City Water account)TRANSFER WATER SERVICE (Stop existing City Water service at current address and start)START ADDITIONAL WATER SERVICE AT A NEW ADDRESS (Keep existing account active)
For START WATER SERVICE: Enter start date below

MonthDayYear
Start date for new service
For TRANSFER WATER SERVICE: Enter end date for current service and start date for new service below

MonthDayYear
End date for current service
MonthDayYear
Start date for new service
For START ADDITIONAL WATER SERVICE AT A NEW ADDRESS: Enter start date below

MonthDayYear
Start date for new service
Residential ServiceCommercial/Business Service

Residential Customer Information
Name*

First NameMiddle NameLast Name
Last 5 digits of Social Security Number*
Date of Birth*

MonthDayYear
Date
E-mail Address*
example@example.com
Previous home address (for I.D. verification purposes)*

Street Address

Street Address Line 2

CityState

Zip Code
Done with Residential Info?

Commercial/Business Customer Information
Business Name*
Name of Authorized Representative of Business Completing This Form*
Tax Identification Number*
E-mail Address*
example@example.com
Previous physical address (if applicable)
Done with Commercial Info?

Contact Info
Primary Contact Phone Number*
example: 123-456-7890
Type*
Secondary Contact Phone Number
example: 123-456-7890
Type
Address to start new service*
City*
State*
Zip Code*
Address to stop current service (transfers only)
City
State
Zip Code
Mailing address for monthly statement (if different from service address):
City
State
Zip Code
OwnRentOther
YesNo
I would like to add authorized users to this account
User 1

First NameLast Name
Last 4 digits of social
User 2

First NameLast Name
Last 4 digits of social
Comments or additional information
PLEASE REVIEW THE FOLLOWING INFORMATION AND CHECK EACH BOX
When water service is off at a home or business, fixtures can be unknowingly left in the on position. To prevent a possible flooding of the property, the technician is unable to leave service on if the meter detects flow and no one is present at the location. If a second trip to restore service is necessary, a fee of $15.00 will be charged to your account.All requests for service are assessed a New Account Fee of $30.00 and a Service Charge of $15.00. The fees are non-refundable and non-transferrable. The fees will appear on your first month’s bill.The City of Columbia has a right pursuant to the South Carolina Setoff Debt Collection Act to collect any sum due and owed by the applicant through offset of the applicant’s state income tax refund. If the City of Columbia chooses to pursue debts owed by the applicant through the Setoff Debt Collection Act, the applicant agrees to pay all fees and costs incurred through the setoff process, including fees charged by the Department of Revenue.Identification Verification The City of Columbia uses Equifax Identification Systems to complete an I.D. verification.
The undersigned hereby applies to the City of Columbia for a water/sewer supply, to be furnished through a meter, for which service the undersigned agrees to pay a monthly rate and minimum charge (whether the minimum volume of water is used or not) as may be established by the City of Columbia in accordance with its ordinances. It is understood and agreed that the applicant will comply with all rate schedules, rules, regulations and ordinances of the City of Columbia in connection with this service; that the City reserves the right at any time without notice to interrupt water service for maintenance, repairs or extensions without any liability to the undersigned or owner of such premises for damages resulting there from; that the undersigned will not receive water from any part of the City water system without a valid permit from the City engineer or without an in-service meter.

It is understood and agreed that at any future time should any part of the property described above become contiguous to the city limits of the City of Columbia, the owner will cause that property to be annexed. In this event, the City of Columbia reserves the right to discontinue service until the above described property is annexed.

The undersigned agrees to notify the City of Columbia when he/she desires to have this service terminated. Water Customer Service shall be allowed five (5) days after the receipt of such notice to take a final reading of the meter and to discontinue service. Your account responsibility does not end until a final reading of the meter is obtained and a bill marked “Final Bill” is mailed (you cannot terminate an account the same day service is requested).

By typing my full legal name in the box below, I agree to the City of Columbia’s terms of service and verify that I am the person applying for service at the location provided.
Full Legal Name*
Date*

MonthDayYear
Date
Submit: Click this button to send your application and PDF form to us.

Preview/Print: Click this to preview your form as a PDF before it is sent. You can also print your form, scan it and send it to WaterContracts@columbiasc.gov. Alternatively, please fax the printed form to (803) 733- 8219.

Save: Click this button to save your form before submitting. You can come back later to finish. You will be sent a link to your email to return.
Should be Empty:

City Of Columbia Application for Water Service Contract

Residential Customer Information

Commercial/Business Customer Information

Contact Info

I would like to add authorized users to this account