JOINT ACCOUNT APPLICATION

Application below is hereby made to the Coweta County Water and Sewerage Authority to supply water and/or sewer service. The applicants agree to take and pay for service according to the Terms and Conditions of the Authority at the described property as shown on this application. The applicants further agree to give prompt written notice to the Authority in the event the applicants' desire to discontinue service. Failure to do so will render applicants liable to the Authority for all water charges assessed against the subject premises until such time as actual written notice is received by the Authority. 

Activation Fee: $75 (If you are purchasing a meter this will not apply)

Same-day activation between 2 and 4 pm: Additional $50 (If you are purchasing a meter this will not apply)

Date Service Desired (AVAILABLE MON-FRI ONLY, NO HOLIDAYS):*

**Please note that the waiting period for meter installations is a minimum of 4-6 weeks from the date payment is received.

***Please note that you will still need to come by the office and pickup the flag(s).

Primary Account Holder*
Primary Account Holder's Date of Birth*
ex. 123121234
Would you like to sign up for paperless statements?*
Please note - only one e-mail address per account can receive e-mailed statements.

Please note there is a $2.50 fee for each paper statement mailed.

XXX-XXX-XXXX
Secondary Account Holder*
Secondary Account Holder's Date of Birth*
XXX-XX-XXXX
XXX-XXX-XXXX
Service Address*
Billing Address (Where you want your bill sent)
Authorized user to access account (not account holder)
XXXX
Applicant Description*
Type of Residential Service*
Type of Residential Service*
Water capacity fee of $1,400 applies to all new service addresses using 3/4" meter. Fee varies for larger meters. // Irrigation meters are placed on existing water line.
I have read and understand the backflow prevention requirements*
Residential: Do you own a swimming pool ?
Do you wish to enroll in the Leak Coverage Program?

Leak Coverage assists customers who receive a large bill due to a water leak. If you choose to opt-out and have a leak, you will be responsible for the FULL amount of your bill.

Please review the details of our DRIP Program, located here. The DRIP Program is a charity program that will round-up your water bill to the nearest dollar. ALL funds raised through this program support local charities.

Do you wish to enroll in the DRIP Program?

The DRIP program is part of our mission to be a steward in the community.  The funds raised from customers are donated to local non-profits in Coweta County that focus on helping Coweta residents in financial need. 

Submit Proof of Residence/Occupancy*
No File Chosen
File uploads may not work on some mobile devices.
If you have not yet closed, you can provide your contract or purchase agreement.
If renting, please provide lease agreement.
Optional Second Upload for Proof of Residence/Occupancy
No File Chosen
File uploads may not work on some mobile devices.
Submit Identification of primary account holder (typically driver's license)*
No File Chosen
File uploads may not work on some mobile devices.
Submit Identification of secondary account holder (typically driver's license) *
No File Chosen
File uploads may not work on some mobile devices.
Plat*
No File Chosen
File uploads may not work on some mobile devices.


By submitting this application you agree that you have read the Terms and Conditions as well as understand your responsibilities incurred by your request for water or water/sewer service. Furthermore you understand the rate structure for water or water/sewer. You also understand that you will be responsible for any and all cost associated with the recovery from any delinquent accounts, including but not limited to reasonable attorney's fees and costs for collection or with a collection agency. 


By submitting this application, you agree to this policy.

I have read and understand the terms and conditions*
Use your mouse, finger, or stylus to sign.
Use your mouse, finger, or stylus to sign.
Date*

If you do not receive a confirmation email or contact from a Customer Care Representative within 24 hours of submitting your application you must call our office at 770-254-3710. Submitting the application without confirmation does not guarantee service.

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