Application For Connection

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Old North State Water Company, LLC

PO Box 10127 

Birmingham, AL 35202

Applicant #1:
Applicant #2:
Applicant Role:
Mailing Address
Service Address
Information Applicant #1
Contact Phone #:
Information Applicant #2
Contact Phone #:
Email:
Old North State Water Company, LLC is prohibited from disclosure of any personal information except as may be required by a Court of Law
Date to Start Service
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Customer Agreement (Owner)

As the owner, I hereby accept responsibility for all charges pertaining to water / waste water service and will not compromise the proper operation of water / waste water sanitary sewer being provided in any manner. I understand that any unpaid balance may result in service being discontinued.

Customer Agreement (Tenant) 

As the tenant, I hereby accept responsibility for all charges pertaining to waste water service and will not compromise the proper operation of waste water sanitary sewer being provided in any manner. I understand that any unpaid balance may result in service being discontinued.

I am a
Owner / Tenant Signature
Date
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Please help reduce high call volume by emailing info@onswc.com instead of calling if you need assistance accessing your new online account. PayNSeconds is no longer available for Kanata Mills, Sterling Crest, or Olde Mill Trace customers because we have implemented a new software system. Customers who make payments via billpay, mailing a check or who have set up ACH autodraft over the phone are not impacted by this change.