PUBLIC UTILITIES

 

Tenant / Lessee / Land Contract Form

(for water and/or sewer service)

 

*If you are a property owner, you need to go back and select the owner form.

Tenants and Lessees must include a copy of a lease or a letter from the property owner.

Tenant / Lessee / Land Contract Form for Water and/or Sewer Service

There is a separate form for Property Owner's; this form is only used for tenants, lessees, and land contract customers.
DEPOSIT REQUIRED

A $100 deposit is required of all tenants, lessees, and land contract customers.
Our office will contact you after we have received your contract and you may pay the deposit over the phone (or you may come into the office to pay with cash or check).
We are unable to put water/sewer services into your name without a deposit.

Include Apartment / Suite Numbers if Applicable

This number will only be called if the office detects a water leak at your home or other urgent business matters.
This email address will only be used for urgent business matters with the City of Circleville.
This number will only be called for urgent matters such as large water leaks.

This field must be completed if your lease, rental agreement, or land contact has more than one name.
This number will only be called if the office detects a water leak at your home or other urgent business matters.
This email address will only be used for urgent business matters with the City of Circleville.
This number will only be called for urgent matters such as large water leaks.



COMMERCIAL PROPERTY ONLY
FID # (provide if you are a business and want the account in the business name)
COMMERCIAL PROPERTY ONLY
Contact Name & Phone Number (if you are contracting under a business name)
Please enter the contact person and phone number, if this service is in a business name.

This agreement is made and entered into between the City of Circleville, Department of Utilities, and (enter name in the space). Hereafter referred to as "tenant" for service at (enter address in the space).

This agreement is subject to al City of Circleville’s Ordinances and Laws, now in force or which shall later become in force, and all rules are regulations of the City of Circleville Department of Public Utilities.


Tenant states that he/she has the consent of the owner of the premises, and hereby agrees to become responsible for and to make prompt payment of all water and/or sewer charges and fees connected therewith. Tenant acknowledges that the City of Circleville may disconnect the water services of the premises, if services and charges are not paid when due, and that such services will not be reconnnected to the premises until the amount due is paid in full.


I understand that water/sewer is granted solely on the basis of the personal information submitted as part of this agreement, and I do certify that all such information is correct. I agree that this application for service, when accepted by the City of Circleville, shall form a binding agreement governing the terms of all water and sewer rendered to me by the City of Circleville. No refund shall be made for an amount less than One Dollar ($1.00). Payments must be received in the Utility Office before 4pm on the due date to avoid paying the "AFTER DUE DATE" amount.

Click or drag a file to this area to upload.
The names on this contract must match all names on the lease / rental agreement.

SERVICE ADDRESS INFORMATION


Other Business Use

Please take a moment to read through the following information.

Office Hours: 7:30am – 4:00pm, Monday-Friday. Closed on major holidays.
Office Location: 108 E Franklin St., Circleville, OH 43113


We offer several methods of making payment…
There is an afterhours drop box, which is located to the right of our office door.
You may pay by postal mail or in person at our office location.
You can pay by cash, check, money order, or credit/debit card in office.
We can set your account up with automatic bank payments, free of charge, which are drafted the day before the bill due date.
For your convivence, we offer phone and online payments, which are supported by a third party. There is a convenience fee of $3.90 for phone payments (740-477-8255 option 1) or $2.95 for payments using our City of Circleville website).


All water/sewer bills are due on the 20th of each month. If the 20th falls on a Saturday, the bills will be due on the 19th. If the 20th falls on a Sunday, the bills will be due on the 21st. If the payment is not received by the due date a 10% late fee is added to the account.


Any property, which is unpaid on the disconnection processing day, regardless if a tag has been delivered or of if the property is shut off or not, is subject to a $25 service charge. The disconnection process begins on the 2nd Friday of each month; the final date to pay is always the Thursday prior.


If water is disconnected for nonpayment, it will not be restored until the full past due amount and the $25 service charge is paid. Upon payment, water services will not be restored until the following business day. If you wish to have water services restored the same day, you must pay the full past due, the $25 fee, and the current bill so you’re your account reflects a zero balance.


DEPOSIT REQUIRED

A $100 deposit is required of all tenants, lessees, and land contract customers.
Our office will contact you after we have received your contract and you may pay the deposit over the phone (or you may come into the office to pay with cash or check).
We are unable to put water/sewer services into your name without a deposit.

CONTACT US

  • 108 E. Franklin St,
  • Circleville, OH 43113
  • Monday – Friday
  • 7:30 a.m. – 4:00 p.m.