24 Hour Customer Service: 479-621-1142 About Us Careers Contact Us Bids and Contracts [gtranslate] New Customers Billing and Rates Pay My Bill Current Residential Water Rates Other Fees Water Leak Policy Services and Information Start or Stop Service New Customer Application Rogers Boundary Map Fees List FAQs Online Account Management Online Account Help Apply Online for New Service New Service Request (New Meter Install) Residential Billing and Rates Pay My Bill Current Rates Other Fees Water Leak Policy Services and Information Online Account Help Start or Stop Service Transferring Service Fees List FAQs Building/MEP and Fire Protection Approved Backflow Prevention Devices Cross Connection and Backflow FAQs Approved Backflow Testers Business Billing and Rates Pay My Bill Current Rates Impact Fees Other Fees Services and Information Online Account Help Start or Stop Service Transferring Service Fees List FAQs Requirements and Guidelines Food Service Establishments Healthcare Facilities Industrial Pretreatment/EPA Compliance Building/MEP and Fire Protection Approved Backflow Prevention Devices Cross Connection and Backflow FAQs Approved Backflow Testers Developers and Contractors Development Standards and Guidelines Plan Review Checklist Plan Review Fee Policy RWU Standard Specifications and Details Rogers Boundary Map Utility Extension Permit Commercial/Industrial Requirements Construction Impact Fees Arkansas Contractor Licensing Board Current Bond Requirements Bore Permits and Agreements Fire Hydrant Meter Application and Policy New Service Request (New Meter Install) Inspection Requests Facilities Extension Contract Repair Service Authorization Tree Removal Form Building/MEP and Fire Protection Backflow Tester Portal Fire Hydrant Flow Test Request Approved Backflow Prevention Devices Approved Backflow Testers Cross Connection and Backflow FAQs Food Service Establishment Questionnaire Current Bids and Tabulations Your Water Water Quality Beaver Water District Annual Reports Rogers Water Utility Water Quality Reports Beaver Water District PFAS Fact Sheet Rogers Pollution Control Facility Improvement Efficiency and Leak Detection Tips Possible Causes of Higher-than-Average Water Usage Do I Have a Leak? Indoor Self-Audit Water Leak Policy Water Conservation Tips Winterize Your Water System Protect From Freezing RWU in the News Working Together Strengthening Wastewater Systems in NWA Reducing Water Loss With Continuous Monitoring Sensors Reducing Water Loss – Detailed Case Study GIS Mapping Rogers GIS Maps Rogers Water Utility Service Line Inventory RWU Capital Improvement Projects Rogers Waterworks & Sewer Commission The Commission Meeting Agendas Meeting Minutes Commission Audio Public Reports Financial Audit Reports Rogers Water Utility Water Quality Reports Beaver Water District Annual Reports Repair Service Authorization Home > Repair Service Authorization The undersigned hereby authorizes Rogers Water Utilities to perform the requested repair, relocation, replacement, or modification of utility facilities described below. I understand and agree that I am responsible for all costs associated with this work, including labor, materials, equipment, restoration, and any additional work necessary to complete the requested service. I further understand that this authorization does not represent a final invoice and that actual charges will be based on the work performed. Customer Information Name*: Company Name (if applicable): Mailing Address*: City*: State*: Zip*: Phone #*: Email*: Contact Person (if different): Contact Phone #: Project Information Service Address (Location of Work)*: City*: State*: Zip*: Reason for Request / Description of Work: Customer Acknowledgement By signing below, I certify that I am the property owner or an authorized representative of the property owner and authorize Rogers Water Utilities to perform the work described above. I understand that I am responsible for all costs associated with the requested work and acknowledge that final charges may differ from any preliminary estimate based on the actual labor, materials, equipment, restoration, and site conditions encountered during construction. Printed Name*: Signature*: Date*: * Please only click once * Questions? Rogers Water Utilities Phone: 479-621-1142 Email: field@rogerswaterar.gov More Information Rogers Water Utilities Boundary Map Repair Service Authorization Form Sample Easement Plan Review Check List Plan Review Fee Policy RWU Standard Specification Access and Development Fees Meter Sizing Chart Fire Hydrant Meter Application Fire Hydrant Meter Policy Bore Permits Utility Extension Permits Customer Care Call: 479-621-1142 Fax: 479-621-1146 Email: se*****@***********ar.gov Physical Address: Rogers Water Utilities 601 S 2nd Street Rogers, Arkansas 72756 Mailing Address: Rogers Water Utilities P.O. Box 338 Rogers, Arkansas 72757 Still Have Questions?
