City of Farley's Temporary Utility Service Change Request

Temporary Utility Service Change Request

If you plan to be away from your home or business for an extended period of time, please contact the City Clerk's Office to discuss your City of Farley utility service and billing options.

Program Description: Your property must be vacant for at least one FULL billing cycle to utilize this program. The program will only run for the extent your property is vacant for the whole billing cycle. Billing cycles run on a calendar month basis, starting on the 1stof the month and ending on the last day of the month. This program will not run on a rolling calendar month basis, and service fees will not be prorated for partial billing cycle vacancies. This program will also not run retroactively: requests must be submitted before the billing cycle commences. If a request is received after a property has been vacated, the program will initiate on the first billing cycle after receipt of the request, if the property will be vacant for that full billing cycle.

Statement 1: Whether you leave water service on or have it shut off, please remember that you are responsible to ensure all systems in your home are adequately protected from damage that could occur during your extended absence. If you are not sure how to properly secure your furnace, plumbing, water heater, water softener or any other appliance, please seek the advice of a professional.

Statement 2: The City of Farley accepts no financial responsibility for damages, and will not forgive large water and sewer service bills resulting from water leakage or unauthorized usage, etc. during your absence.

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Please choose the option below that best suits your service and billing needs. If no option is checked, the City will apply OPTION THREE to your account. You will be billed for the utility services received in the month prior to approval of this request. Please make arrangements to pay your bill if you are not signed up for ACH automatic payments.

INACTIVE ACCOUNT STATUS: NO monthly bills and NO monthly meter readings. Disadvantage: leaks and unauthorized usage may not be apparent without monthly meter readings.

*OPTION ONE: WATER SHUT OFF AT THE STREET No water, sewer, or garbage services available. Make an appointment to turn your water back on; a $25.00 reconnection fee will be charged to your account at the time service is restored.

*OPTION TWO: KEEP WATER ON AT THE STREET Water and sewer services are available for use; garbage service is discontinued for the length of your request.

ACTIVE ACCOUNT STATUS: Regular monthly billing and meter readings. Advantage: leaks and unauthorized usage may be detected with monthly meter readings.

*OPTION THREE: KEEP WATER ON AT THE STREET, GARBAGE INACTIVE Regular bills must be paid as usual each month. Water and sewer services are available for use. Garbage service is discontinued for the length of your request.

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You may either complete and submit this online form, or print, complete, and submit the paper form attached:

Temporary Utility Service Change Request

* Please enter your initials here to acknowledge your understanding of Statement 1.:

* Please enter your initials here to acknowledge your understanding of Statement 2.:

* Date Leaving:

ex: 12/27/1987

* Date Returning:

ex: 12/27/1987

* Full Name:

Utility Account Number:

* Address of Property to be Vacant:

* Mailing Address (during absence):

* Phone Number:

ex: (612) 555-1234

E-Mail Address:

* Reason for Request/Vacancy:

* Emergency Contact Name:

* Emergency Contact''s Phone Number:

ex: (612) 555-1234

* Choose the option that best suits your service and billing needs.:

Inactive Account Status: Option 1
Inactive Account Status: Option 2
Active Account Status: Option 3

* Signature: by typing your full name here, you authorize that you understand and accept the provisions of the option you selected above.:

* - denotes required field



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