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Owner Information:

Account number (required)

First Name (required)

Last Name (required)

Service address (required)

Mailing address (required)

City (required)

Zip code (required)

Phone number (required)

Email (required)

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Secondary Party (Tenant) Information:

First name (required)

Last name (required)

Mailing address (required)

City (required)

Zip code (required)

Phone number (required)

Email (required)

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I recognize that this does not relieve me of responsibility for any delinquent or unpaid charges or related costs should they occur. As the legal deeded owner, I am solely responsible for all costs associated with this account.

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OWNER SIGNATURE

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

Date (required)

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Printable Form

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An Ordinance of Calaveras County Water District
Modifying Rates for Water and Wastewater Services

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Guide outlining our current wastewater demand factors

Construction Standards - Calaveras County Water District

Engineering Department - Calaveras County Water District