This is the exact embedded text of the captured official document.
Snapshot d6c2faff5f4d · verified 2026-06-09 ·
original document ·
archived snapshot ·
unofficial consolidation, the official version is held by the municipal clerk.
CUSTOMER'S WORK ORDER/AUTHORIZATION
REQUEST FOR CHANGE TO WATER SERVICE
Date/Time of Request:
Request Made By:
PROPERTY INFORMATION
ADDRESS:
WATER ACCOUNT #:
Will someone be home?
Yes
No
*Note: If water is being turned ON, someone is
required to be home
Phone Number:
Request made by:
Owner/business operator
contractor
POA
Work to be preformed:
Turn water on
Fee: $30.00 (Authorised person must be
present)
Turn water off
Fee: $30.00
Turn water on & off
Fee: $60.00 (same day/regular business hours)
*Note: Additional charges may apply if the requested time is outside of business hours or if the request
is not a same day service.
Payment Information:
Paid at time of request
To be Invoiced
Mailing Address:
To the best of my knowledge, there is no dispute with any tenant(s) at the above
location. Please preform the above noted work. To be completed by Township Staff:
Confirmed off by:
Name:
Date/Time:
Confirmed on by:
Name:
Date/Time: