I Want Service

Print
Press Enter to show all options, press Tab go to next option

Please correct the field(s) marked in red below:

Residents interested in receiving water and/or sewer services in their residential area are encouraged to let us know by filling out the survey below.  Your input is valuable to our planning process for new capital improvement projects.

If you have any questions, please feel free to contact our office:
Palm Bay Utilities Department
250 Osmosis Drive SE
Palm Bay, FL  32909
Email
321.952.3410

1
GENERAL CONTACT INFORMATION
 *
GENERAL CONTACT INFORMATION
2
I would like the following city services in my residential area:
I would like the following city services in my residential area:
3
Tell us why you would like City water and/or sewer in your residential area (select all that apply):
Tell us why you would like City water and/or sewer in your residential area (select all that apply):
4
Would you like a member of our staff to contact you?
Would you like a member of our staff to contact you?
5
If you answered yes to the previous question, how would you prefer to be contacted?
If you answered yes to the previous question, how would you prefer to be contacted?
  1. To receive a copy of your submission, please fill out your email address below and submit.