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2. 
3. Connect Water Utility Services - Rental Property
   Please complete the online form to connect water utility services. Additional information may be requested to complete the utility service connection. Contact the City of Lafayette Utility Billing for questions regarding a complete list of services we provide at the property by calling 303-665-5588 or email utilitybill@lafayetteco.gov.
5. Today's Date*
   Today's Date
6. Connection Date*
   Connection Date
   Today's date or a future connection date. We are unable to back date your connection services.
8. First Name*
9. Last Name*
11. First Name
    Co-Occupant
12. Last Name
    Co-Occupant
14. Rental Property Address*
16. Rental Property Address
18. City*
19. State*
20. Zip*
22. Email Address*
23. Phone Number
25. This form is being completed by:

    1. Tenant
    2. Landlord/Owner
    3. Property Management Company
27. Name of Landlord/Property Management Company*
28. Landlord/Property Management Contact Information
Leave This Blank:


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

    This field is not part of the form submission.

32. Submit

* indicates a required field