DocuSign Envelope ID: 6511944B-AF53-4B2A-B0E5-F8E46DD25D63
DocuSign Envelope ID: 6511944B-AF53-4B2A-B0E5-F8E46DD25D63
Application for Water and/or Sewer Service
CITRUS COUNTY UTILITIES
3600 W. Sovereign Path * Lecanto, Florida 34461
PHONE: (352) 527-7650 * FAX: (352) 527-7644
Email: waterresources@citrusbocc.com
ID yourself as Property Owner, Tenant or Agent and PROVIDE SUPPORTING DOCUMENTATION ________
ID as Residential or Commercial Property: _________________________________________________________
Utility Account Holder Name(s):
Utility Service Address:
Billing Address:
(If different from utility service address)
Best Contact Phone Number:
Alternate Phone Number:
Last 4 Social Security Number(s): ________________/ ________________
Driver’s License Number(s):
_______________________________________State:_____________
_______________________________________State:_____________
Email Address: _________________________________________________________
Date Requesting Service(s) To Be Turned On: _________________________________
If you would prefer to receive “paperless” monthly bill statements by email, please initial here: _______ .
Bill Statements will be emailed from address: no-reply@invoicecloud.net with the subject “Citrus
County”.
Lobby/ Phone Hours
PLEASE MAKE ALL CHECKS PAYABLE TO: CITRUS COUNTY UTILITIES (CCU).
Lobby, 8:00am-4:30pm
Phones, 8:00am-5:00pm
Customers are responsible for updating CCU with current contact information.
PLEASE ALLOW 24-48 HOURS TO PROCESS ALL APPLICATIONS FOR NEW SERVICE.
**Once we receive your application and required paperwork, we will contact you for payment.**
Customer’s Signature(s): ________________________________ / ____________________________________
"Please Note: Florida has a very broad Public Records Law. Most written communications to or from State and Local Officials
regarding State or Local business are public records available to the public and media upon request. Your email communications
may therefore be subject to public disclosure."
