Forms

Apply For Service

Sign up for Blountville Utility District service by filling out the application below, printing the application for completion and dropping it off at our office, or visiting our office at 3010 Highway 126, Blountville, TN 37617.

*New Service Requirements

  1. Completed signed copy of Blountville Utility District “Service Application”
  2. Completed signed copy of Blountville Utility District “Well Users Agreement”
  3. Picture ID, or some other form of identification of all applicants
  4. (a) Formal lease/rental agreement
    (b) Formal purchase/ownership agreement

Submit Completed Forms Here

As an alternative to dropping forms and required documents to the office, you can submit completed forms below. Failure to submit a fully completed form with required documentation may result in delayed execution of services requested.

Customer Contract/New Tap Service Application

Disconnection of Service

Temporary Service
Agreement

Stop-Terminate
Debit Authorization

Service Tap Requirements

Multiple Connections

Other Forms

Bank Draft Form

Change of Address

Name Change Form

Rates & Fees

Leak Claim

Water Quality Report