Forms

Apply For Service

Sign up for water service at Blountville Utility District by filling out the Service Application below. 

The application may be submitted:

  1. In person: 3010 Highway 126, Blountville, TN 37617
  2. Emailed: [email protected]
  3. Uploaded: to the dropbox listed below
 

Failure to submit a fully completed form with required documentation may result in delayed execution of services requested.

After application is submitted, a customer service representative will reach out for payment of connection fee for the service. See “Rates & Fees” file below for these amounts.

*New Service Requirements

  1. Completed signed copy of Blountville Utility District “Service Application” (This includes completion of page 3 “Well Users Agreement”)
  2. Picture ID, or some other form of identification of all applicants listed on the application
  3. (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.

Service Application / New Tap Application

Disconnection of Service

Temporary Service
Agreement

Stop-Terminate
Bank Draft Form

Service Tap Requirements

Multiple Connections

Other Forms

Bank Draft Form

Change of Address

Name Change Form

Rates & Fees

Leak and Line Protection Information

Water Quality Report