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New Utility Service Form


  1. 1. Residential Utility Application
  2. 2. City of Melissa Service Agreement
  3. 3. Notice of Right to Request Confidentiality
  4. 4. Sign & Submit
  • Residential Utility Application

    1. Numbers only, no dashes.
    2. Requested service date must be no more than two weeks from the date of service form submittal. Same-day service requests can only be honored if the form is submitted prior to 2:00 p.m.
    3. Property Type:*
    4. I have had utility service through the City of Melissa before:*