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2. Septic Information Update Form
   Use this form to update the City records regarding septic systems on your property(ties). Enter contact information below.
4. Name (First and Last)
5. Email Address
7. Phone Number
9. Enter the Tax ID and Address
   Enter your address for each property you would like to update.
11. Address
12. Date of Connection
    Do you know an approximate year this property was connected to WVWA sewer service?
14. Address
15. Date of Connection
17. Address
18. Date of Connection
20. Address
21. Date of Connection
23. Address
24. Date of Connection
26. Address
27. Date of Connection
29. Check the box below to confirm.

    1. I certify that the property(ties) at the Address(es) entered above DOES NOT have a septic tank and is connected to WVWA service.
31. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that this information is correct to the best of your knowledge.

    1. I agree.
33. Electronic Signature
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field