Form Center

2. 
6. MCUS Utility Service Application
8. Applicant's Name*
9. Service Address*
11. Mailing Address (if different from service address)
13. City*
14. Date to Begin Service*
    Date to Begin Service
    Select the date you wish service to be transferred into your name.
16. State*
17. Zip*
19. Phone Number*
20. Email Address*
22. Select Services*

    MCUS provides Monticello residents with water, sewer and refuse/recycling via Republic Services. Please check the boxes below to indicate which services you require.

    1. Water/Sewer
    2. Residential Refuse & Recycling
24. Do you want your phone number entered into the community notification system to receive alerts on boil orders, public works projects and community emergencies?*

    1. Yes
    2. No
26. Are you new to the Monticello community?*

    1. Yes
    2. No
28. Emergency Contact*

    Please provide the name and phone number of an alternate contact in case we are unable to reach you.

30. Applying As:*

    **If you are a renter or mobile home dweller, you must pay a $100 deposit to the MCUS office before service will be transferred into your name.
    **Landlords must complete a separate application.

    1. Owner and Resident of the Property
    2. Renter of the Property
    3. Mobile Home Dweller
32. Landlord/Property Owner
    If you are a renter, please provide the name and phone number of the landlord/owner of the property.
33. Signature of person making the request*
35. Do you agree?*

    By clicking "I agree," 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 agree that your "electronic signature" is valid and binding upon you to the same force and effect as a handwritten signature 3) You agree to abide by and be bound by all provisions of the City of Monticello Ordinance 4) You accept responsibility for all unpaid utility bills.

    1. I Agree
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit Submit and Print

* indicates a required field