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This form is for property owners only. If you are a tenant or landlord, click here.

You may apply for service by completing this form or calling 703.698.5800 during our normal business hours, which are between 8:00am and 6:00pm ET, Monday through Friday. Please note that we do not schedule service requests on weekends or holidays.

Please review the information we will need. We rely on you to give us complete information. Incomplete requests may delay the processing of your account.

Are you an Owner or a Tenant?

Name 1

Name 2

Organization Name

First Name

Middle Initial

Last Name

Address

City

State

Zipcode

Daytime Phone

Evening Phone

Mobile Phone

Email

Address

P.O. Box

Address (cont.)

City

State

Zipcode

Are you a previous or present customer of Fairfax Water?

Yes

No

If yes, please provide service address (Owner Only)

What date would you like your service to begin?

Click text box above to select date.