Service Forms

FieldWorkers

Forms

This page contains some common forms that are used by BPSUD. For your convenience, each form is supplied .PDF format. The .PDF format requires you to have Adobe Acrobat Reader installed on your computer. Adobe Acrobat Reader is free for everyone to download from the Adobe website.

get_acrobat Click on the image to download Adobe Acrobat Reader.
Simply follow the onscreen instructions on the Adobe Website (www.adobe.com)

 

For New Construction:

Service Application (2 Pages)
This form is for requesting a new water service connection.

adobe icon Service Application

Application for Temporary Service (1 Page)
This form is in addition to the Service Application for a brand new construction (recently constructed building never before receiving water service). Must be submitted with the above Service Application.

adobe icon Application for Temporary Service

Utility Easement (1 Page)
This form is used to grant a land easement to BPSUD to install and maintain water lines and meters. This form is required for all new water service customers.

adobe icon Utility Easement

Early Notification / Identity Theft Protection Form (1 Page)
This form is used to inform BPSUD of phone numbers / email addresses to contact you for our Early Notification System. Also the Identity Theft Protection Information portion is a question that a Customer Service Representative can use to verify your identity when you call about information concerning your account. This form is required for all new water service customers.

adobe icon Early Notification / ID Protection Form

 

 

For Existing Service:

Service Application (2 Pages)
This form is for requesting a new water service connection.

adobe icon Service Application

Utility Easement (1 Page)
This form is used to grant a land easement to BPSUD to install and maintain water lines and meters. This form is required for all new water service customers.

adobe icon Utility Easement

Early Notification / Identity Theft Protection Form (1 Page)
This form is used to inform BPSUD of phone numbers / email addresses to contact you for our Early Notification System. Also the Identity Theft Protection Information portion is a question that a Customer Service Representative can use to verify your identity when you call about information concerning your account. This form is required for all new water service customers.

adobe icon Early Notification / ID Protection Form

 

Other Forms:

Automatic Payment Authorization (1 Page)
This is an authorization form to give BPSUD permission to draft your bank account for water service payment.

adobe icon Automatic Payment Authorization

Change of Address Form (1 Page)
This is a form to request a change in mailing address for bills.

adobe icon Change of Address Form

Confidentiality Request Form (1 Page)
This form is to request certain information regarding your account to be confidential.

adobe icon Confidentiality Request Form

Public Information Request Form (1 Page)
This form is to request information from BPSUD to be released to you pursuant to the Public Information Act.

adobe icon Public Information Request Form

Service Termination Request Form (1 Page)
This form is for requesting a disconnection of your existing water service.

adobe icon Service Termination Request Form

Duplicate Billing Form (1 Page)
This form is for requesting a duplicate bill to be mailed each month to another person. A fee applies for this service.

adobe icon Duplicate Billing Request Form

Developer Packet (16 Pages)
This packet is designed to assist developers that would like to apply for water service to a new subdivision. The packet includes the steps to follow and the application that will need to be submitted with plans and a fee for engineering review.

adobe icon Developer Packet

Requirements for RV Parks (1 Page)
This form is for requesting service for an RV Park. The form details requirements and meter sizing, per number of sites.

adobe icon Requirements for RV Parks Form