How do I submit the tenant service application?

The form lists the Town of Mineral at 312 Mineral Avenue, Mineral, VA 23117, but does not give submission instructions. Check the town website for current contact details.

What information does the application ask for?

It asks for the applicant’s name and contact details, service and billing addresses, requested connection date, and property owner’s information.

Are there deposits or fees for service?

The form lists water and sewer deposits, where provided, and a $25 processing fee. It states that the deposit is required before connection and the processing fee is non-refundable.

Mineral, VA · Louisa County

No notary required

Application for Water and/or Wastewater Usage (Tenant)

Tenants use this application to request Town of Mineral water and/or wastewater service and provide contact, service location, and property owner information.

What this form is

This application is for tenants requesting water and/or wastewater service in the Town of Mineral. It asks for the applicant’s contact and service address, billing address if different, requested connection date, and property owner information. A signed Tenant/Landlord Agreement is required before connection, and the form lists required deposits and a processing fee.

Who needs it

A tenant requesting water and/or wastewater service at a Mineral property needs to complete this application and provide the property owner’s information.

How to submit it

The form lists the Town of Mineral at 312 Mineral Avenue, Mineral, VA 23117, and provides a phone and fax number. It does not state how to submit the application.

About notarization

This application is signed and dated without a notary; the required Tenant/Landlord Agreement must be signed, but the form does not require notarization.

How to submit this form

1
Download the Application
Download the Town of Mineral tenant water and/or wastewater usage application.
2
Complete the Application
Enter the requested service date, applicant and property details, contact information, and applicable deposit and fee amounts.
3
Gather the Agreement
Have the Tenant/Landlord Agreement signed, as the form requires it before water or wastewater service connection.
4
Submit to the Town
The form lists the Town of Mineral at 312 Mineral Avenue, Mineral, VA 23117; it does not specify submission instructions.

Frequently asked questions

Do I need a notary for the Tenant Water and/or Wastewater Usage Application?: No. The application is signed and dated without a notary. A signed Tenant/Landlord Agreement is required before service connection, but the form does not require notarization.
How do I submit the tenant service application?: The form lists the Town of Mineral at 312 Mineral Avenue, Mineral, VA 23117, but does not give submission instructions. Check the town website for current contact details.
What information does the application ask for?: It asks for the applicant’s name and contact details, service and billing addresses, requested connection date, and property owner’s information.
Are there deposits or fees for service?: The form lists water and sewer deposits, where provided, and a $25 processing fee. It states that the deposit is required before connection and the processing fee is non-refundable.

Need something notarized?

This Application for Water and/or Wastewater Usage (Tenant) doesn’t need a notary — but if you have another Mineral form that does, a commissioned online notary can help.