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Select Type of Service Account:*

Residential Service (includes solid waste, recycling, bulk/brush, hazardous waste collection)
Commercial/Non-residential Service
Irrigation Only (Watering Livestock &/or Vegetation)
Contractor’s (Temporary)

Certificate of Occupancy Number*

You must be able to provide your certificate of occupancy (CO) number in this field before moving forward with this application. If you have not been issued a CO number then you will need contact Justin French, Director of Planning & Development, before being allowed to move forward. You can reach Justin French at j.french@robinsontexas.org or by calling (254) 662-1415 ext. 2500

City*

Home Phone

Work Phone

Cell Phone*

Email Address

The Service Address Is:*

Owned
Rented (identify landlord in next area)
Other (explain)

If the type of service address is not listed below please use the next area to provide that information. Use this area to identify the landlord, if need be.

Other (Explain)

Does the service account have an OSSF (Onsite Sewage Facility/Septic Tank)*

Yes
No

Provide the Date you would like services to begin.*

Provide the Date you would like services to begin.

Connects and disconnects will not be completed on weekends or city observed holiday's. For a list of city observed holidays visit https://www.robinsontexas.org/652/City-Observed-Holidays. If you choose a date that falls on a weekend or city observed holiday, the connection will not be made until the next following business day.

How would you prefer your statement to be sent to you?*

Electronic Billing
Paper Mailing
Both (Electronic/Paper Billing)

Email Address for Electronic Billing*

If you would like to sign up for e-billing, please provide the e-mail address you would like the bill sent to.

Have you ever had your water service cut-off for non-payment or delinquent payment of your bill at any previous address where you have lived (if you or your spouse were the customer on the account?)*

Yes
No

If “Yes”, explain, including identification of the approximate date(s) (if known) and the water service provider(s).*

1st Address*

2nd Address*

Name of closest relative not living at the service address*

Upload Copy of Driver's License Here*

A copy of your driver's license must be submitted with your application before service can begin.

Upload Lease Agreement Here*

A copy of your lease agreement must be submitted with your application before service can begin.

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