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Welcome to the City of Saginaw, Texas!

Application for New Water Utility Service
You picked a WONDERFUL community to call home. To start a water account online, you will need to complete the Application (below) and Service Agreement Form. Once you click the "Submit" button below, you will be directed to the Service Agreement Form. Completed forms will be automatically emailed to us after submitted. You will then need to email a copy of your government issued ID and a copy of the first page and the signature pages of either your lease or the Settlement Statement/Closing Disclosure. A payment in advance of $115.00 is required of all accounts. Of the $115.00, $100.00 will be applied to the customer's final water bill. Any remaining credit will be refunded. After we receive the request, we will email an account number and pin to allow you to go online to pay the payment in advance. YOUR REQUEST WILL NOT BE PROCESSED UNTIL ALL REQUEST FORMS ARE RECEIVED. Your application will be processed within 48 business hours.
Applicant Status (check one):*
1. Owner/Landlord
2. Owner/Offsite
1. Owner/Occupant
2. Roommate
1. Property Owner
2. Tenant/Renter
Occupancy Status (check one):*
1. Vacant for Make-Ready (to sell)
2. Vacant for Make-Ready (to rent)
1. Owner Occupied
2. Owner and Roommate
1. Occupied by Tenant/Renter
Does this property have a pool or irrigation system? (check all that apply)*
1. Pool
1. Irrigation
1. N/A
Start Date:*
Start Date:
Service Address:*
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Applicant Information

Applicant Name:*
Mailing Address:*
City:*
State:*
Zip Code:*
Email*
Preferred Method of Contact (check one):*
1. Email
2. Paper
3. Both
Home Phone
Cell Phone*
Work Phone
Driver's License*
Driver's License State:*
Date of Birth*
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Acceptance and Agreement:

Today's Date:*
Today's Date:
Signature:*
Have you ever had service with Saginaw before? (check one):*
1. Yes
1. No
If "YES", provide address:
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Co-Applicant Information (if applicable):

Co-Applicant's Name
Co-Applicant's Drivers License
Driver's License State:
Co-Applicant's Date of Birth
Co-Applicant's Work Phone
Co-Applicant's Home Phone
Co-Applicant's Cell Phone
Co-Applicant's Email Address:
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Service Agreement

I. PURPOSE. The CITY OF SAGINAW is responsible for protecting the drinking water supply from contamination or pollution which could result from improper system construction or configuration on the retail connection owner's side of the meter. The purpose of this service agreement is to notify each customer of the restrictions which are in place to provide this protection. The public water system enforces these restrictions to ensure the public health and welfare. Each retail customer must sign this agreement before the CITY OF SAGINAW will begin service. In addition, when service to an existing retail connection has been suspended or terminated, the water system will not re-establish service unless it has a signed copy of this agreement.
II. RESTRICTIONS. The following unacceptable practices are prohibited by State regulations.
a. No direct connection between the public drinking water supply and a potential source of contamination is permitted. Potential sources of contamination shall be isolated from the public water system by an air-gap or an appropriate backflow prevention device.
b. No cross-connection between the public drinking water supply and a private water system is permitted. These potential threats to the public drinking water supply shall be eliminated at the service connection by the installation of an air-gap or a reduced pressure-zone backflow prevention device.
c. No connection which allows water to be returned to the public drinking water supply is permitted
d. No pipe or pipe fitting which contains more than 0.25% lead may be used for the installation or repair of plumbing at any connection which provides water for human use.
e. No solder or flux which contains more than 0.2% lead can be used for the installation or repair of plumbing at any connection which provides water for human use.
3. SERVICE AGREEMENT. The following are the terms of the service agreement between the CITY OF SAGINAW (the Water System) and you at this address.*
a. The Water System will maintain a copy of this agreement as long as the Customer and/or the premises is connected to the Water System.
b. The Customer shall allow his property to be inspected for possible cross-connections and other potential contamination hazards. These inspections shall be conducted by the Water System or its designated agent prior to initiating new water service; when there is reason to believe that cross-connections or other potential contamination hazards exist; or after any major changes to the private water distribution facilities. The inspections shall be conducted during the Water System's normal business hours.
c. The Water System shall notify the Customer in writing of any cross-connection or other potential contamination hazard which has been identified during the initial inspection or the periodic re-inspection.
d. The Customer shall immediately remove or adequately isolate any potential cross-connections or other potential contamination hazards on his premises.
e. The Customer shall, at his expense, properly install, test, and maintain any backflow prevention device required by the Water System. Copies of all testing and maintenance records shall be provided to the Water System.
IV. ENFORCEMENT. If the Customer fails to comply with the terms of the Service Agreement, the Water System shall, at its option, either terminate service or properly install, test, and maintain an appropriate backflow prevention device at the service connection. Any expenses associated with the enforcement of this agreement shall be billed to the Customer.
Copy of your Government Issued ID Card*
1. Yes
1. No
Upload Copy of ID Card*
Upload Copy of Additional Form of ID (if applicable)
First Page and the Signature Pages of either "Your Lease" or the Settlement Statement/Closing Disclosure*
1. Yes
1. No
Upload Copy of Your Lease/Closing Disclosure*
Signature*
Today's Date:
Today's Date:
***NOTE: Please you may either upload these files or send a copy of your driver's license and lease agreement/closing papers to: ubilling@saginawtx.org
Sample Closing Disclosure
Sample Closing Disclosure
Customer's Signature*
Today's Date:*
Today's Date:

Leave This Blank:

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

This field is not part of the form submission.
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Application for Water Utility Service

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Service Agreement

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