Move In Request Form

2. Move In Form (Start Services)
   <p><font size = "2">This form is used to notify the Utility Billing staff of an upcoming Move In (purchase) of a property. City staff will use the Move In date as the service start date. <b>This form is only for owners of the property. Renters are not allowed to set up services with the City.</b> <p><br>The City provides residential properties in Blaine with Water, Sewer, Storm Water, Garbage, and Recycling services. Residential properties are billed on a quarterly basis, all services are billed on a single statement. <p><br><b>You will be responsible for the utility services from the date submitted on this form, unless staff is notified before closing or within 10 days after the scheduled closing date. Staff can be reached at 763-785-6141, Monday thru Friday, 8AM to 4:30PM.</b></font size>

   This form is used to notify the Utility Billing staff of an upcoming Move In (purchase) of a property. City staff will use the Move In date as the service start date. This form is only for owners of the property. Renters are not allowed to set up services with the City.

   
   The City provides residential properties in Blaine with Water, Sewer, Storm Water, Garbage, and Recycling services. Residential properties are billed on a quarterly basis, all services are billed on a single statement.

   
   You will be responsible for the utility services from the date submitted on this form, unless staff is notified before closing or within 10 days after the scheduled closing date. Staff can be reached at 763-785-6141, Monday thru Friday, 8AM to 4:30PM.

4. Move In (Start Date)*
   Move In (Start Date)

5. Is this a Rental Property?*

   1. Yes
   2. No

6. Are you the Renter?*

   1. Yes
   2. No

8. Service Address*

   Address of the home purchased.

10. Name (First and Last)*

11. Email Address

12. Phone Number*

14. Services Billed
    Water ($5.50 + Usage) <br>Sewer ($60.00/Qtr.) <br>Stormwater ($10.00/Qtr.)

    Water ($5.50 + Usage)
    Sewer ($60.00/Qtr.)
    Stormwater ($10.00/Qtr.)

15. Garbage Cart Size*

    Please Select a Garbage Cart Size. Standard recycling cart is 96 gallons.

    1. 38 Gallon ($39.00/Qtr.)
    2. 68 Gallon ($49.50/Qtr.)
    3. 96 Gallon ($63.00/Qtr.)
16. Garbage Service Level and Rates
    Rate Breakdown and Cart Size Comparison (New Window)

    Click to get a breakdown of Garbage Rates and approximate number of kitchen bags each cart size holds.

20. Alternate Mailing Address
    Must be completed if rental property is selected.

    Must be completed if rental property is selected.

22. Name

24. Address

26. City

27. State

28. Zip Code

32. Additional Question

34. Notice
    You can consider this form accepted after you click submit. Your account will be set up on the date entered above. Staff will only contact you if we have questions with the information provided.

    You can consider this form accepted after you click submit. Your account will be set up on the date entered above. Staff will only contact you if we have questions with the information provided.

Leave This Blank:


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

    This field is not part of the form submission.

37. Submit