UTILITY SERVICES APPLICATION/AGREEMENT

Filling out the following form will speed up your application process. However, you still NEED TO PRESENT a valid government issued ID ( driver's license or passport/tarjeta consular) in our office before a work order for your service is put in place. If you have any questions, please call customer service representatives at 801-229-7275.
*Property Address
*Ownership
*Property Type
*Applicant's Name
*Requested Service Date    
* Your complete application and the copy of your ID need to be in our office by 2 PM in order to receive same day service.
Spouse/Co-Signer Name [Optional]  
*Mailing Address
*Paperless Billing
*Applicant's ID Type *License/Passport #  
*Phone   *Date of Birth
*Applicant's Prev. Address  
Employment Information
Applicant Employer Name   Employer Phone #
Spouse Employer Name Employer Phone #
Emergency Contact Information
*Name
*Relationship
Address/*City/*State  
*Phone No.
* This page is not applicable for business account!
Please select the number of cans you want. However, the first garbage can is required per living unit.
1st Can ($10.65) Additional Can (9.65) Recycle Can ($3.20) Green Waste Can ($5.70)
* Recycle is picked up every other week on your garbage day
* Green waste is Mar 1st. - Nov 30th every week on garbage day. You will only be billed the $5.70.
* Price is per can.

If you are a new resident to our city, you might want to know the following important phone #:
Rocky Mountain Power: 1-888-221-7070  |  Questar Gas: 1-800-323-5517  |  Qwest Telephone: 1-800-244-1111
  • Fees and Charges
  • Terms and Conditions
Water Base Rate – Varies according to property’s meter size
Water Usage – Monthly meter reads from March through October (March bill has 5 months winter water usage)
Sewer Base Rate
Sewer Charge – Set at City average for the first year
City Franchise Tax
Garbage Charge – Recycling and Green Waste services available at additional cost
Storm Sewer
Street Lighting – depending on property location
1. I/we, the undersigned, hereby apply for services with the City of Orem for the above premises and agree to pay a monthly fee for watersupplied which is due within 30 days of being invoiced. The rate, as well as other fees, charges and fines related to water service, is established by resolution of the City Council. Failure to receive a bill or an e-mail notification (for paperless billing) does not relieve customer of liability.
2. A NON-REFUNDABLE $15 LATE FEE is assessed to all accounts that are not paid IN FULL by the DUE DATE.
3. An account setup fee of $25.00 will be included in the first bill.
4. The account shall be subject to termination of services upon non-payment or failure to comply with rules, regulations, ordinances, or laws as established by the City.
5. Water service shall not be restored after being shut off until all money owed, including deposits, fines, fees, and penalties have been paid in full.
6. All bills sent to water users shall be deemed to be correct if they are not disputed within sixty (60) days from issuance.
7. There will be a charge on all returned checks in the maximum amount allowed by state law and customer agrees to pay the same.
8. By requesting services, the applicant agrees to keep current all payments and agrees to pay all costs of collections (not to exceed 40% of the bill), including reasonable attorney fees and interest if the account becomes delinquent.
9. Applicant here by warrants and affirms that the information provided in this form is true and correct to the best of his/her knowledge. Applicant also affirms, understands, and agrees to comply with provisions of this utility application for services.
Confidential Information (Passwords)
*SSN/Tax ID if a Business *Re-Type SSN/Tax ID
*Acct. Access Password *Re-Type Acct. Access Password
*Email