Application for Water, Sewer, & Refuse Services

Water, Sewer, and Refuse Collection services are provided by the Department of Public Utilities and are available in different areas of the County. Refuse Collection is an optional service where available. Contact us at 804-501-4275 for information on these services or to establish service with Henrico County. You may also complete and submit this application electronically or print and mail the completed application to the address listed below. It is advisable to call the County at 501-4275 to confirm receipt of this application and that your account has been established.

Private refuse collection services are also available throughout the County.  Information on available companies can be found in various resources, such as the Internet, your local phone book and other publications.

 

Date Service Required (mm/dd/yy) / /

Service Address:
Address No. Street Direction
Street Name Type
Apt./Unit

Type of Customer (check one):
Residential Commercial Apartment or house rental

Residential Customer Information

Customer Name:
Title First Middle Initial Last Suffix
Daytime Phone# ( ) (Important. Please verify accuracy.)
Place of Employment

If applicant is a tenant:
Owner or Landlord's Name
Owner or Landlord's Phone # ( )


Commercial Customer Information

Business Name Federal ID #
Kind of business or activity
Business Phone # ( )

 


Alternate Contact Information

Spouse, other name on lease/deed, or additional contact name:
Title First Middle Initial Last Suffix

Daytime Phone # ( )
Place of Employment

Billing Information

Is billing address different from service address?

Yes No

If yes, please complete following:
C/O

Mailing Address:
Address No. Street Direction
Street Name Type
Apt./Unit
City State Zip Code

If applicant is purchasing the property:

Closing Attorney or Real Estate Agent's Name
Phone # ( )

 

Customer's Previous or Current Address in Henrico County:
Address No. Street Direction
Street Name Type
Apt./Unit

If current, should this account be closed? If yes, when? (mm/dd/yy) / /

Curbside Trash Collections:

Do you want the County of Henrico Refuse Collection Service if available in this area ($30.00 bi-monthly)?

Yes No

Note:

A $14 account set-up fee will be included on the first regular bill. If a customer is not the property owner, a bill for a $100 security deposit will be mailed. A customer service representative will call to confirm application and may gather additional information.

Completed applications can also be mailed to:

County of Henrico

Department of Public Utilities

P. O. Box 90775

Henrico, VA 23273-0775

Public Utilities


Copyright 1996-2010 Henrico County 4301 East Parham Road, Henrico, VA 23228