Skip to Main Content
Do Not Show Again
How Do I?
Select a Category
Building Department/Fire Marshal
Nassau Bay Police
Parks & Recreation
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Water Termination Form
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
WATER TERMINATION FORM
Please complete this form to allow us to finalize your water account with the City of Nassau Bay.
This form must be submitted at least one business day in advance to allow us enough time for your account to be processed.
Water Service will be shut-off if we do not have the new owner/renter’s information on file to establish new service in their name.
Name(s) on Account:
(If date requested falls on a weekend, the account will be finalized on the following business day.)
Final Billing Address:
City / State
Name of Person Making Request:
Contact Phone Number:
Please type your name acknowledging the above information you have provided is correct.
Leave This Blank:
Receive an email copy of this form.
This field is not part of the form submission.
* indicates a required field
How Do I?
Slideshow Left Arrow
Slideshow Right Arrow