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1. Residential Application for Utility Services (Water, Sewer & Garbage)(current) This section is complete This section is incomplete
2. Step Two This section is complete This section is incomplete
3. Applicant Information This section is complete This section is incomplete
4. Co-Applicant Information This section is complete This section is incomplete
5. Automated Draft Information This section is complete This section is incomplete
6. City of Rosenberg Service Agreement This section is complete This section is incomplete
7. Solid Waste (Garbage) Service This section is complete This section is incomplete
8. Connect With Us! This section is complete This section is incomplete
9. Acknowledgements This section is complete This section is incomplete

Residential Application for Utility Services (Water, Sewer & Garbage)

Requirements for New Service
1. A completed application
2. One (1) form of identification from applicant(s). Must be a valid Texas driver's license (DL) or a photo ID card issued by the Texas Department of Public Safety (DPS).
3. If you do not have a Texas issued DL or ID, Two (2) forms of ID will be required.
4. Initial deposit of $150. For senior citizens whose age is 65 or over, initial deposit is $80. (Must be paid before services can be activated). You may email documentation to customerservice@rosenbergtx.gov or there is an "file upload" feature towards the end of the application. Once we have received and reviewed your application and documentation, one of our customer service representatives will contact you to pay the deposit over the phone.
5. Rental properties: If the property is not registered as required by the Residential Rental Registration Program, you may be unable to activate water service under your name.
If you have any questions regarding your application, you may call our Customer Service Department at 832-595-3400 during normal business hours or you may email them at customerservice@rosenbergtx.gov.
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Step Two

Service Start Date*
Service Start Date
Note: New Service activation will be processed the next business day. For same day service requests, a service initiation fee of $20.00 will be charged. Application and related documents must be received before 4:30pm if requesting same-day service. Water service connection can only be accommodated on weekdays. The City is unable to start water service on weekends or holidays. Utility services to this address will not be furnished if you owe a delinquent bill at a previous or present address, or if all the required paperwork and information are not provided. Only applicants will be allowed to make changes or inquire on this account.
Please indicate if you are the:
1. Owner
2. Renter
3. Existing Customer
Additional Information for Rentals
If you are renting, please fill out the following information. If you are not renting and are the property owner, please continue to the next section.
Landlord Name
Landlord Phone Number
Residential Rental Registration Permit Number
Service Address*
Street Address
City
State
Zip Code
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Applicant Information

Applicant Name*
First and Last Name
Mailing Address
If different from Service Address
City
State
Zip Code
Home Phone
Cell Phone*
Email*
Date of Birth*
Date of Birth
Would you like to enroll in e-Bill services and receive your monthly bills via email? Note: By selecting "Yes", you will not receive a paper copy*
1. Yes (please note the monthly bills will be emailed to the email address entered above)
2. No
Photo ID
Please upload a copy of your Driver's License or Identification Card.
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Co-Applicant Information

Co-Applicant may make inquiries to account
Co-Applicant Name
First and Last Name
Email
Phone Number
Photo ID
Please upload a copy of your Driver's License or Identification Card.
Do you or co-applicant currently have an active utility service account with the City?*
1. Yes
2. No
If answered "Yes" from previous questions, what is your current service account address
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Automated Draft Information

Authorization for Automated Bank Draft Payments. If "Yes", Please upload a copy of voided check below.*
1. Yes, I authorize the City of Rosenberg, Texas to initiate debit entries to my checking or savings account
2. I do not wish to participate at this time
Voided Check
Please upload a copy of a voided check.
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City of Rosenberg Service Agreement

I have read and agree to the terms listed in the following service agreement between myself and the City of Rosenberg.*
1. I agree
I. Purpose: The City of Rosenberg is responsible for protecting the drinking water supply from contamination or pollution which could result from improper private water distribution system construction or configuration. The purpose of this service agreement is to notify each customer of the restrictions to ensure the public health and welfare. Each customer must sign this agreement before the City of Rosenberg will begin service. In addition, when service to an existing connection has been suspended or terminated, the water system will not re-establish service unless it has a signed copy of this agreement. II. Restrictions: The following unacceptable practices are prohibited by Sate regulations. A. No direct connection between the public drinking water supply and a potential source of contamination is permitted. Potential sources of contamination shall be isolated from the public water system by an air-gap or an appropriate backflow prevention device. B. No cross-connection between the public drinking water supply and a private water system is permitted. These potential threats to the public drinking water supply shall be eliminated at the service connection by the installation of an air-gap or a reduced pressure-zone backflow prevention device. C. No connection which allows water to be returned to the public drinking water supply is permitted. D. No pipe or pipe fitting which contains more that 0.25% lead may be used for the installation or repair of plumbing at any connection which provides water for human use. E. No solder or flux which contains more than 0.2% lead can be used for the installation or repair of plumbing at any connection which provided water for human use. III. Service Agreement: The following are the terms of the service agreement between the City of Rosenberg (the Water System) and the Applicant & Co-Applicant's Printed Name A. The Water System will maintain a copy of this agreement as long as the Customer and/or the premises is connected to the Water System. B. The Customer shall allow his property to be inspected for possible cross-connections and other potential contamination hazards. These inspections shall be conducted by the Water System or its designated agent prior to initiating new water service; when there is reason to believe that cross-connections or other potential contamination hazards exist; or after any major changes to the private water distribution facilities. The inspections shall be conducted during the Water System's normal business hours. C. The Water System shall notify the Customer in writing of any cross-connection or other potential contamination hazard which has been identified during the initial inspection or the periodic re-inspection. D. The Customer shall immediately remove or adequately isolate any potential cross-connections or other potential contamination hazards on his premises. E. The Customer shall, at his expense, properly install, test, and maintain any backflow prevention device required by the Water System. Copies of all testing and maintenance records shall be provided to the Water System. IV. Enforcement: If the customer fails to comply with the terms of the Service Agreement, the Water System shall, at its option, either terminate service or properly install, test, and maintain an appropriate backflow prevention device at the service connection. Any expenses associated with the enforcement of this agreement shall be billed to the Customer. For information regarding water quality and FAQs, visit https://www.rosenbergtx.gov/water-disinfection nd https://www.rosenbergtx.gov/water-faqa
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Solid Waste (Garbage) Service

For solid waste/recycling collection schedule, guidelines or additional information, please visit https://www.rosenbergtx.gov/trash or you may call GFL at 832-271-5187.
Do you currently have a garbage cart?*
1. Yes
2. No
Do you currently have a recycle cart?*
1. Yes
2. No
If not, would you like to request a garbage and recycle cart?*
1. Yes
2. No
3. N/A
Please make sure there are currently no carts at the service address. If carts are currently there and more are requested, you will be billed for additional carts. Note: Carts will be delivered within 5 business days from the date requested.
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Connect With Us!

Sign up for notifications regarding utility services (water outages, boil water advisory, delinquent notices, etc...)*
1. Text
2. Phone
3. I would not like to receive notifications
The City has a new emergency notification system! Please select any or all below types and stay informed of trusted neighborhood public safety and community information.*
1. RTOWN for City related notifications
2. RPDALERTS for Police related notifications
3. RFDALERTS for Fire related notifications
4. REVENTS for City Special Event notifications
5. I would like to receive ALL notification types
6. I would not like to receive any notifications
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Acknowledgements

I understand that the City requires a one working day notice to connect service. If same-day service is required, a $20 service initiation fee will be charged.*
1. I understand and agree
I understand that the City will not initiate service if the meter clearly indicates that water is running. There is a $15 charge for each subsequent trip to initiate service.*
1. I understand and agree
I understand and have read the policies and procedures for residential service. The policies and procedures document may be found on the 'Forms' page of the Utility Services page at https://rosenbergtx.gov/DocumentCenter/View/748/Residential-Policies-and-Procedures-PDF*
1. I understand and agree
I understand that $150 deposit ($80 for senior citizens over the age of 65) will need to be paid before activation of services.*
1. I understand and agree
I hereby declare and affirm, by 'signing' my name(s) below, to the best of my knowledge and belief, all statements and answers as stated herein are full, complete, and true. I, the undersigned, fully understand that I am responsible to pay for utility service or other charges which may become due to the City of Rosenberg at this address. All persons who sign this application shall be jointly and severally liable for any water, sewer, and garbage service charges incurred at this service address.*
Please type in your name as your "signature"

Leave This Blank:

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

This field is not part of the form submission.
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New Utility Service Online Application

Steps

Residential Application for Utility Services (Water, Sewer & Garbage)

Step Two

Applicant Information

Co-Applicant Information

Automated Draft Information

City of Rosenberg Service Agreement

Solid Waste (Garbage) Service

Connect With Us!

Acknowledgements

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