Utility Application

For a printable version of the application click here.

Riverdale City Utility Application

To be filled out by the property owner.

* Indicates required field

Property Owner / Entity Name *

Co-Owner Name *

First

Last

Property Acquisition Date *

Service Address *

Owners Mailing Address (if different) *

Primary Phone Number *

Secondary Phone Number *

Email *

Select One *

Commercial Residential

Select One *

Owner Occupied Renter Occupied

Workplace *

Work Phone Number *

Emergency Contact *

Emergency Phone *

REQUIRED FOR RENTAL OR COMMERICAL PROPERTY

Manager Name *

First

Last

Manager Phone Number *

Current Occupant Name *

First

Last

Current Occupant Phone *

Address to Mail Bill *

I hereby apply for all mandatory and necessary utility services provided by City of Riverdale and agree to pay all service charges applicable for the property listed above which may include any or all of the following, i.e. water, sewer, garbage, and storm drain as fixed by the City of Riverdale. In the event of failure to pay the utility bill, I understand the City is authorized to shut off the water to this property, at its election and without further notice to me. The undersigned further agrees to be bound by all the rules and regulations of the Ordinances of the City of Riverdale for the control of its utility systems. In the event that payment is defaulted, the owner is financially responsible for any unpaid balance.

I understand that by signing this agreement I give permission for the city and its affiliates to make contact regarding this account and the associated charges using the information provided on this form. The undersigned specifically agrees to pay all reasonable attorneys’ fees and court costs in the event legal action is taken to collect on the account.

The undersigned, legal owner/agent of the property described above hereby applies for utility service and does hereby agree to abide by the rules and regulations for the City of Riverdale for the installation and operation of said service and to pay the charge fixed by the city. Payments for utility bills are due before 5:00 pm on the last working day every month.

I hereby agree I am responsible for purchasing garbage and recycle cans at the city's current cost. *If the prior owner has left the cans behind, I agree to keep them in good condition and to leave the cans on the property should I move.

The undersigned further agrees that any and all amounts owed by the applicant which are six months past due shall constitute a lien against the property served and herein described. The City of Riverdale agrees not to file this agreement as a record in the county recorder's office, unless and until any amount due for such service has become six months past due.

Applicant / Officer / Authorized Agent's Signature *

First

Last

Driver License # and State of Issuance *

Today's Date *

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance

Required *

I AGREE

Information submitted through this form is only collected for official Riverdale City utility business. All records are subject to and protected by UCA 63G-2, Government Records Access and Management Act.

Submit