New Customer Form

New customers will need to pay a $25 new account fee prior to service being established.

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

Address Requesting Water Service(Required)

Street Address

Billing Address Different from Service Address

Billing Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Requested Date of Service Connection(Required)

Water Leak Adjustment Form

Please fill out the Aqua Water Leak Adjustment Request Form below. All items on the below form are required in order for the form to be submitted.

Name(Required)

First Last

Email(Required)

Service Address(Required)

Street Address

Account Number(Required)

Phone(Required)

Leak Fixed Date(Required)

Describe the nature of the leak and how it has been repaired.

Repair/Invoice Receipt(Required)

Max. file size: 50 MB.

Name(Required)

First Last

Phone Number (for verbal authorization)(Required)

Service Address(Required)

Street Address

Date(Required)

Royal Gorge Water Utility
PO Box 128, Ridgecrest, NC 28770
(828) 669-3993
Billing@royalgorgewater.com