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Water and Sewer Contact Information

  1. For multiple account numbers please list at the bottom of the form.

  2. Receive emails*

    Check if you would like to receive emails from the City of Belmont

  3. Receive Text Messages*

    Check if you would like to receive text messages from the City of Belmont

  4. Please provide us the name of anyone else you would like to authorize to your account.

  5. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. By signing below I have read and agree to the Parents Code of Conduct

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  7. This field is not part of the form submission.