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2. Water Shut-off Request
   48 hour notice is REQUIRED for water shut-off at the curb stop. If this is an emergency please contact the Department of Public Works at (414) 847-2650.
4. 
5. Today's date*
   Today's date
6. Request Shut-off Time
   Request Shut-off Time

   Request Shut-off Time
   Time is not guaranteed and must be coordinated with Utility Foreman.
8. Has plumbing permit application been filed?*
   -- Select One --yesno
10. Property address*
11. City*
13. First Name*
    Name of requesting party
14. Last Name*
16. Phone Number*
18. Plumbing contractor (if applicable)
20. Plumber's telephone number
22. Acknowledge Fee*

    1. I acknowledge and accept $40.00 fee.

    Per the Wisconsin Public Service Commission, a re-connection fee shall apply. A $40.00 fee will be added to the property's next issued utility bill.
24. Staff Use Only
    Employee initials if submitted by staff.
Leave This Blank:


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

    This field is not part of the form submission.

28. Submit

* indicates a required field