Application For Connection-NC

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Old North State Water Company, LLC

Integra Water, LLC 

PO Box 10127 

Birmingham, AL 35202

Applicant #1:
Applicant #2:
Applicant Role:
Mailing Address
Service Address
Information Applicant #1
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Information Applicant #2
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Email:
Old North State Water Company, LLC is prohibited from disclosure of any personal information except as may be required by a Court of Law
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Customer Agreement (Owner)

As the owner, I hereby accept responsibility for all charges pertaining to water / waste water service and will not compromise the proper operation of water / waste water sanitary sewer being provided in any manner. I understand that any unpaid balance may result in service being discontinued.

Customer Agreement (Tenant) 

As the tenant, I hereby accept responsibility for all charges pertaining to waste water service and will not compromise the proper operation of waste water sanitary sewer being provided in any manner. I understand that any unpaid balance may result in service being discontinued.

I am a
Owner / Tenant Signature
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COVID 19 ALERTWe believe it is critical to do our part to reduce the transmission of COVID-19.

----------------------- Due to COVID-19 State of Emergency ---------------------------

Integra Water will suspend late payment fees and disconnections of service due to non-payment for those impacted by the pandemic. Customers who are affected and have difficulty paying their bills should contact Customer Service (877) 511-2911