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Water Account Card

  1. If different than service address

  2. Phone*

  3. FOR RENTER'S ONLY

  4. CONTRACT

    I hereby request the City of Seaside to supply service as heron, until the receipt of formal notice from me requesting discontinuance of this service. I agree to pay for such service promptly each billing according to the statement shown by the meter at the regular rates applicable for such service as provided in the Rates, Rules, and Regulations of the City of Seaside which have been approved by the City Council

  5. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  6. Please check one:*

  7. Leave This Blank:

  8. This field is not part of the form submission.