New Service Form – Business

APPLICATION FOR SERVICE

Charles Town Utility Board
661 S George Street, Charles Town, WV 25414

Items required to setup new service:
Picture ID for owner and employee submitting the application.
Proof of residency. If renting: rental or lease agreement signed by all parties. If purchasing: any document displaying applicant as the owner of the property.
Application signed by business owner.
Deposit. Amount varies, please check with cashier.

ALL CHARLES TOWN RESIDENTS ARE REQUIRED TO CONTACT APPLE VALLEY WASTE FOR TRASH PICKUP.
PLEASE CALL (304) 724-1834 FOR SERVICE.

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Address for Service
Address for Bill
Own or Rent Location
Service can be stopped or started during business hours only.
I HEREBY AUTHORIZE SERVICE TO BE ESTABLISHED IN MY NAME AT THE ABOVE PROPERTY LOCATION AND AGREE TO PAY FOR SERVICE UNTIL DISCONTINUED BY MY REQUEST IN WRITING