Water & Garbage Service Application

2. Please DO NOT fill this out if you are a Renter as we do not put ANY utilities in the Renter's name. Please speak with your landlord regarding the billing. 

   **We do not service Vintage on the Bluffs (Cabernet Dr., Brunello Dr, Napa Ave., Chardonnay Wy, Julien Cv, Rutherford Ave, Sonora Wy, Sonora Ct, Almaden Cv & Bridgeview Ct) **

4. Please note, that during the time of February 16th-February 25th we will not be processing Final Bills or Setting up New Accounts as the Technician will be out of town. 

6. Purpose of Application:*

   1. New Construction
   2. Existing House
   3. Existing & Rental Property
   4. Rental Property
   5. Commercial

   Check here if this is a rental so the Tenant will receive a courtesy copy of the bill. This also cannot be paperless. Please note due to Bluffdale's Policy on Rentals the Property name will ALWAYS remain in the Property Owner's Name and the Tenant will receive a courtesy copy to the physical address. 

   
   

7. Proof of Purchase:*

   Please attach a picture of the Closing Statement from your Closing Documents showing your Name, Address & the Date of Closing. NO Real Estate contracts or deeds. NO password-protected documents.

   If this is a past due contract, please just attach the email or letter you received for proof of purchase.

8. Date of Closing:*
   Date of Closing:

   *Disbursement Date on the Closing Disclosure*

   Bluffdale City automatically transfers utility services (water, sewer, and garbage) into the new property owner's name as of the closing date, unless the previous owner has made prior arrangements with our office — such as a signed agreement to rent the home back or a request to delay the final billing. If no such agreement is in place, the utility account becomes your responsibility from the date of closing.

9. One time set-up Fee

   A Set-up fee of $40 will be added after setup.

   If this is a past due contract after you have been setup you were already billed the $40.00 and this will NOT be applicable.

13. Billing Name:*

    PLEASE DO NOT LEAVE BLANK THIS MUST BE FILLED OUT (Must be Property Owner)

14. Additional Property Owner's Name

    (Must be Property Owner)

15. Service Address:*

    *Address where Services are requested. We do not need City, State & Zip Code.*

16. Mailing Address:

    (Required on a Rental if different then the Physical Service Address, please include Zip Code, City & State)

18. Phone Number*

    Please list a valid phone number in case we need to get a hold of you for any type of emergency situation. Please double check the number you add.

    ****If this is a Commercial Property, we need the Manager or Owner's direct E-mail for any  billing inquiries, not a 3rd Party payment company. 

19. Phone Number 2

    Please list Spouse, Partner or additional phone number to make sure that you are notified of any type of emergency such as a leak, past due account. If you have listed the same number in the first box, you do not have to list the same in this one.

20. Email Address-Primary*

     Make sure to mark "utilities@bluffdale.gov" as a safe sender as you will receive your Account Number confirmation from this email. Also, double check that all the spelling is correct. 

    **If this is a Commercial Property, we need the Manager or Owner's direct E-mail for any  billing inquiries, not a 3rd Party payment company. 

21. Email Address-Secondary

    Please list an additional e-mail for us to get a hold of you if the first one doesn't go through. If it's the same as your primary, you do not need to add it here.

24. NO SERVICE AREAS

    Please note that we do not service Broad Stripes Drive, Galant Drive, Bright Stars Drive or Commercial

26. Requested # of Garbage Cans:*
    -- Select One --12Bright Stars, Galant & Broad Stripes Dr HOACommercial (NO SERVICE)34

    Green receptacle with a Green lid

    * Basic services, which include 1 Trash & 1 Recycle, are required by Bluffdale City*

    Trash can(s) should be at the property now, if you wish to add more we will deliver them or if you wish to remove extras, please leave them out and empty on the curb to be collected for removal.

    
    

27. # of Recycle Cans:*
    -- Select One --1 2Bright Stars, Galant & Broad Stripes Dr HOACommercial (NO SERVICE)34

    Blue receptacle with a Blue lid

    * Basic services, which include 1 Trash & 1 Recycle, are required by Bluffdale City*

    Recycle can(s) should be at the property now, if you wish to add more we will deliver them or if you wish to remove extras, please leave them out and empty on the curb to be collected for removal.

28. # of Green Waste Cans:
    -- Select One --01Commercial-NO SERVICE2 3Bright Stars, Galant & Broad Stripes Dr HOA

    Green receptacle with a Yellow lid

    *Optional* Green Waste begins in March and ends in November

    If the previous owner had Green Waste can(s), they will be on the property. If you wish to have them removed as this is optional, please leave out and empty on the curb to be collected.

30. Governmental entities must obtain and process only the minimum amount of personal data reasonably necessary to efficiently achieve a specified purpose, retained for required period. Utah Code § 63A-19-401(2)(c)

32. Acknowledgement:

    I, the undersigned, hereby apply for utility services from Bluffdale City for the above-named premises and agree to pay any and all charges incurred for said services (including but not limited to culinary water, storm water, streetlights and garbage collection) in accordance with rates fixed by Bluffdale City. Failure to pay my bill in full by the 25th of each month or having an excessive or extended balance, may result in an interruption or disconnection of service(s). I recognize and consent that a re-connection fee (per fee schedule) will be assessed. Payment in full of all outstanding charges, including the re-connection fee, will be required before services can be restored. Damage By Customer: All damages or injury to the lines, meters or other materials of the city on or near the customer's premises caused by any act or neglect of the customer shall, in the discretion of the city, be repaired by and at the expense of the customer, and the customer shall pay all costs and expenses, including reasonable attorney fees, which may arise or accrue to the city through its efforts to repair the damage to the lines, meters or to other equipment of the department, or collect such costs from the customer. (Ord. 5-27-80-1, 5-27-1980, eff. 5-28-1980) Failure to pay said charges will result in interruption of services. I agree to pay all reasonable attorney fees and other costs incurred by Bluffdale City to obtain collection on this account, whether or not litigation is actually filed.

33. Additional Comments/Information

    If you are moving in after your official closing date, please comment below.
    Unless there is a signed agreement stating that the previous owner is renting back the property, utility services will be billed from the date of closing — even if your move is delayed due to packing or other personal reasons.

35. Electronic Signature*

    1. I Agree

    By checking 'I Agree', you agree to acknowledge that you are the property owner and that your electronic signature is valid and binding in the same force and effect as a handwritten signature.

36. Signature:*
37. Date:*
    Date:
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit Submit and Print

* indicates a required field