Click to Home

City Hall Park Entrance
Info Advanced

Form Centre

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Connection Form - Residential

  1. Full Colour Logo - Vertical.png_thumb.png

  2. If you have any questions about water connection or your water account please contact the Water Desk through phone (780-875-6184 Ext. 2125) or email (

  3. Street/City/Province

  4. I authorize the City of Lloydminster to share details of this water account with my second contact. ie. living with account holder

  5. Should be family member not living with account holder

  6. City of Residence

  7. A deposit of $250 will be charged for any account in a Tenant's name, as well as a service charge of $60.00 is required before utility services will be connected. A representative from the Finance department will contact you within 24 hours of your submission of this form to take your payment information.

  8. "Your name, home phone number, home address, postal code and date of birth are collected under the authority of section 25 of the Local Authority Freedom of Information and Protection of Privacy Act. This information will be used for collection and account information purposes." If you have any questions about the collection, contact the FOIP Head at 780-871-8328.

  9. Leave This Blank:

  10. This field is not part of the form submission.