Rose Valley Water P.O. Box 1444 Green Valley, AZ 85622-1444 623-889-2275 info@rosevalleywater.com First Name (required) Last Name (required) Email (required) Home Phone Cell Phone (required) Mailing Address (required) City (required) State (required) Zip Code (required) Is This Property a Lease or Purchase? LeasePurchase Beginning Date of Lease (required) Length of Lease (required) Landlord/MGMT Co. Name (required) If Management Co., Contact Name Landlord/MGMT Co. Address (required) Landlord/MGMT Co. Phone (required) City of Peoria Sewer/Garbage ACCT #: (required) If Purchase, Close of Escrow Date (required) Title Co. Name (required) Title Co. Phone (required) Escrow # (required) Is this property on Septic? YesNo I agree that service will not be started until I have received a confirmation from Rose Valley Water Co with my start service date. Date (required) Please write your signature in the box below (required) Δ
