NEW ACCOUNT APPLICATION

Printer Friendly PDF
Attention Customers:
Please see the back of your monthly invoice for billing information. Also, visit Lee County Utilities website for important information regarding your new utility account at https://www.leegov.com/utilities
NOTE: All new account requests must be presented with either proof of ownership, a lease or a rental agreement.
*
Account Information
*
*
*
Identification
*
Service Address
Note: If you cannot find your City in the dropdown below, please use this tool to find your Utility Provider
*
*
*
*
Note: Service Application form must be submitted by 12pm (or 4pm if its Friday) for same day service.
Mailing/Billing Address
*
*
*
*
Documentation
Note: File size must be less than 10 MB
*

Example: Sales Contract, Closing Disclosure, Warranty Deed, Purchase Agreement or Lease.

*
Deposit Information
To guarantee payment for water and/or sewer services, a deposit must be paid before services can be initiated. If, after 23 months of un-interrupted service, you have a good credit standing with LCU, the deposit (plus interest) will be credited to your account. If you terminate your service before 23 months have accrued, the deposit will be applied to your final bill. Any remaining credit balances will be refunded to you.

Please Check One:*

I have attached a letter of reference from my previous utility provider OR I will be enrolling for autopay and paperless billing, therefore, request the deposit to be waived. (Residential accounts only.)
I have another service address with LCU with 23 months of un-interrupted service and a good credit standing with LCU and, therefore, request the deposit to be waived.
I intend to pay LCU the required deposit. Please contact Lee County Utilities for the proper deposit amount.
Customer Contract
  1. I hereby request and authorize Lee County Utilities to supply water and/or sewer service to the above described property until receipt of formal notice from me requesting discontinuance of such water and/or sewer service.
  2. I agree to promptly pay for said water and/or sewer service at the rates established by the Lee County Utilities Division and within the time periods delineated in the Lee Count Utilities Operation Manual.
  3. I hereby agree to abide by the rules and regulations applicable to said water and/or sewer service as delineated in the Lee County Utilities Operations Manual.
  4. To cover the costs of obtaining the initial meter read and establishing the billing and accounting records, an initial (non-refundable) service fee will be charged to your first bill.
  5. I will make sure that ALL WATER FIXTURES ARE TURNED OFF BOTH INSIDE AND OUTSIDE OF THE HOME OR BUILDING before the above service turn-on date.
I understand that, if a second trip is required because the water was running when originally turned on, a trip charge will be billed to me.
*
***Important Public Records Notice***
Because Lee County Utilities is subject to Florida's Public Records law, your account information is subject to disclosure to the public. You may be entitled to have this information exempted from public disclosure if you have a legal basis to support it (i.e. a victim of a crime, law enforcement or probation officers, certified firefighters, justices of court, child advocacy personnel, certain government officials, code enforcement officers and human resource personnel).
*
*
NOTE: In the event of a Public Records request, you may be asked to confirm whether the basis for your exemption applies.
Customer or Authorized Agent
Note: Enter your Email below if you would like to receive a confirmation email
*
An electronic or manual signature is required when submitting this form. Write your name in the signature area to submit this form electronically (acceptable per Florida Statue 668.50). If an electronic signature is not possible, the form may be printed, signed and submitted in person, via FAX, or by a scanned copy sent via e-mail. Printer Friendly PDF
Signature*

Use your mouse or finger to draw your signature above

Cancel