Sign Up For New Residential Service

Welcome to Lake Mills! We're happy to be your new utility provider. Please either submit the form below to establish service at your new residence. We are available for connects and disconnects Monday through Friday. We do require at least a 24-hour notice.

Customer Information

Date of New Service *

Name(s) on Account *

Primary Phone *

Secondary Phone

Driver's License Number *

Enter your driver's license number or state issued ID number.

New Address

Street Address *

Apt.

City *

State *

Zip *

Rent or Own *

Rent

Own

New Landlord Name

New Landlord Phone Number

Previous Address

Street Address *

Apt.

City *

State *

Zip *

Primary Phone

Secondary Phone

Rent or Own *

Rent

Own

Previous Landlord Name

Previous Landlord Phone Number

Employer

Employer Name

Employer Phone Number

Spouse or Roommate Information

Name