Silver City Public Works
Application For Utility Services
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Use this form to order new water service within the Town of Silver City service area. All fields must be completed. A deposit of $100.00 is required to activate service. Secure payments are handled through PayPal.
First Name: Last Name:
Mailing Address:
City: State: Zip:
Service Address: Turn on Date: (Mo/Dy/Yr)
City: State: Zip:
Home Phone: - Day Phone: - ext:
E-mail Address: Are you Renting? Yes No
If You Are Renting, From Whom? SSN:
Drivers License# Spouse Name:
Name & Address of nearest relative: DOB: (Mo/Dy/Yr)
Verification:
Enter your name below to indicate that you have read the Important Deposit Information.

I have read the Important Deposit Information.