Water Forms

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City of La Crosse Liability Claim Form
Claim forms must be complete and legible and filed with the City Clerk. All claims are referred to the Legal Department.

Consent to Disclose Utility Customer Information
Pursuant to Wis. Stat. §196.137 (4), the La Crosse Utilities Office is not authorized to disclose customer information as related to account balance, payment history or usage to anyone other than the property owner or those listed as authorized in utility records. If a non-customer would like these details, the Consent to Disclose form must be filled out by the utility customer and returned to the La Crosse Utilities Office.

Fire Flow Test Request Form
The La Crosse Water Utility will provide fire flow test data for the La Crosse Water Utility service area upon receipt of a completed Fire Hydrant Flow Test Request Form. All flow tests performed by third party contractors and/or the Utility must be conducted in accordance with AWWA Standard practices.

Fire Hydrant Use Application & Agreement with Fire Hydrant Policy
Only Authorized users may connect to a fire hydrant with proper metering and backflow prevention. All hydrant users are required to complete the Fire Hydrant Use Application and Agreement prior to use.

Landlord Tenant Agreement Form
Pursuant to Wis. Stat. §66.0809, a landlord of a residential rental property may elect to file the attached with the La Crosse Utilities Office to have the utility account for a property put in a tenants name. With this agreement the utility is then allowed to notify the landlord should a tenant become past due and any tenant who has past due charges transferred to landlord's property taxes will have a statutory lien against their personal assets. This lien can be transferred to the landlord should the landlord pay the tenant's past due charges. For further details, see the attached or contact the La Crosse Utilities Office.

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