Discontinuance of Water Service

Date of Request - must be mm/dd/yyyy format * Required
Date Format: MM slash DD slash YYYY
Premises
Street Address Address Line 2 City State ZIP Code
The discontinuance of water service will be effective on the date service is turned off. It is to be understood and agreed, per the initial application that the applicant will be liable for all water charges accrued until this time.
Name * Required
First Last
Final Bill Mailing Address * Required
Street Address Address Line 2 City State ZIP Code
I hereby request that a representative of the Village of Greenwich turn my water service OFF at the curb. I hereby certify that I am the property owner or his/her representative and have authority to request this service. I also agree to hold harmless the Village of Greenwich for any resulting problems or damage due to this request. Water discontinuance fee is $50.00 payable at time of request.
Signature * Required
Account # * Required
Meter # * Required
Remote # * Required

Village of Greenwich