Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Application For Water or Waste Water Services

  1. YAKIMA COUNTY LOGO.jpg

  2. APPLICATION FOR WATER OR WASTE WATER SERVICE

    **MUST RETURN IN PERSON WITH PHOTO ID**

  3. If your parcel number is unknown, look it up online prior to filling out this form.

  4. IF OCCUPANT OTHER THAN OWNER, LETTER FROM OWNER AUTHORIZING INSTALLATION/BILLING TO BE SENT TO OCCUPANT MUST BE ATTACHED. CURRENTLY ONLY CHECK, CASH, CASHIER CHECK OR MONEY ORDER ARE ACCEPTED FOR PAYMENT.

  5. Structure*

  6. *Must be signed by hand.

  7. Amount Received

    N/A

  8. NOTICE: COST OF INSTALLATION IS NOT COVERED BY PERMIT FEE.

    Installation cost will be billed when charges have been finalized.

  9. The following information is required by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program.



    You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in anyway.

    However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.

  10. Ethnicity

  11. Race

  12. Sex

  13. This institution is an equal opportunity provider.

    Esta institucion es de oportunidad igualada.

  14. Leave This Blank: