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Final Water/Stormwater Request

2. New Owners Information (Buyer)

4. First Name*

5. Last Name*

7. Service Address*

9. Mailing Address*

11. City*

12. State*

13. Zip*

15. Phone*

16. Email Address*

18. The Town of Firestone will not transfer water service or stormwater service into the buyers name without a completed residential water/stormwater application and the required water deposit being received by the Town of Firestone.

    The Town of Firestone will not transfer water service or stormwater service into the buyers name without a completed residential water/stormwater application and the required water deposit being received by the Town of Firestone.

22. Current Owners Information (Seller)

24. First Name*

25. Last Name*

27. Mailing Address*

29. City*

30. State*

31. Zip*

33. Phone*

37. Title Company Information

39. Title Company*

41. Contact*

43. Mailing Address*

45. City*

46. State*

47. Zip*

49. Phone*

50. Fax*

54. Closing Date*

56. IMPORTANT NOTICE - PLEASE READ
    <br><br>Please wait for bill mailed on the fourth of each month. <br><br>The Utility Department asks that a $100 escrow be held for the address above during the winter months and a $200 escrow to be held for the address above during the summer months. If $100 or $200 is not sufficient escrow the Utility Department will contact you by fax with a specific amount listed after receipt of this form. <br><br>The Utility Department will not contact you further unless a higher escrow amount is needed. <br><br>If this property is vacant, been foreclosed on or is in the process of bring foreclosed on please call town hall and get a verbal status of the account. <br><br>The Town of Firestone requires that all new residents fill out a residential water/stormwater application at Town Hall, 151 Grant Ave., Firestone, CO 80520. If the water/stormwater application is not completed and submitted with a water deposit a water/stormwater account will not be set up for the new owner. Please understand that water/stormwater will not be transferred out of title companies or sellers name until the application and deposit is received.

    
    
    Please wait for bill mailed on the fourth of each month.
    
    The Utility Department asks that a $100 escrow be held for the address above during the winter months and a $200 escrow to be held for the address above during the summer months. If $100 or $200 is not sufficient escrow the Utility Department will contact you by fax with a specific amount listed after receipt of this form.
    
    The Utility Department will not contact you further unless a higher escrow amount is needed.
    
    If this property is vacant, been foreclosed on or is in the process of bring foreclosed on please call town hall and get a verbal status of the account.
    
    The Town of Firestone requires that all new residents fill out a residential water/stormwater application at Town Hall, 151 Grant Ave., Firestone, CO 80520. If the water/stormwater application is not completed and submitted with a water deposit a water/stormwater account will not be set up for the new owner. Please understand that water/stormwater will not be transferred out of title companies or sellers name until the application and deposit is received.

58. Check Here*

    1. I have read and understand the above information

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60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit Submit and Print

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