Form Center

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.

Customer Service - Start Canal Water / Authorization of Agent

  1. Water District
  2. Coachella Valley Water District
    Canal Water Service Request - Authorization of Agent (CVWD106)





  3. Property Owner Telephone Number Type*
  4. Is the billing information the same as above?*
  5. Billing Telephone Number Type*
  6. Are you the new owner of the property?*
  7. Will existing users stay on the account?*
  8. Will you be leasing the property?*
  9. Is a well located on your property?*
  10. Active?*
  11. Abandoned?*
  12. Will you be multicropping?*
  13. Water will be used for: (check all that apply)*
  14. Industrial Hemp Certification*

    I hereby certify that I will comply with all federal, state and local requirements as it pertains to the production of industrial hemp, including any federal requirements of the United States Bureau of Reclamation, which owns a portion of the facilities used to provide agricultural water service. CVWD makes no representation or warranty regarding what, if any, federal, state or local requirements may apply to hemp production. Water service may be subject to interruption or termination if CVWD determines, in its reasonable discretion, that USBR, the California Department of Food and Agriculture, or County Agricultural Commissioner has denied, revoked, or changed any of its authorizations, which result in a prohibition against Applicant’s hemp production. Further, it shall be the responsibility of the applicant to provide CVWD proof of valid registration with the County Agricultural Commissioner on an annual basis. Applicant hereby waives and releases CVWD from any and all liabilities, which may arise from Applicant’s use of water service for hemp production.

  15. Parcel Information*
    This Canal Water Service Request – Authorization of Agent form must list the parcel and all additional parcels served by the above meter. This will allow for the proper application of paid Canal water charges to each parcel to which water is actually being delivered.

    CREDIT WILL NOT BE GIVEN TO PARCELS NOT LISTED ON THIS FORM OR TO PARCELS TO WHICH WATER IS NOT ACTUALLY DELIVERED.

  16. Water Orders*
  17. Terms & Conditions*
    I hereby authorize the above named water user, if any, and his/her designees to sign or give orders to Coachella Valley Water District for the delivery of water through this meter. By signing this document, I certify I am the legal property owner for the parcels identified within this application; all information is true and correct. I assume all responsibility for any bills, costs, loss, damage, penalties, charges, or fees associated with this meter under the Regulations of the District. This authorization shall be revocable at any time upon written notice to the District. A $30 Account Establishment Fee will appear on my first bill. I acknowledge and agree to comply with all District Regulations, Ordinances, Policies and Rules, and amendments thereto. Where the demand for water exceeds the available water supply, water orders may be delayed except under emergency conditions as determined by the District. Service may be interrupted for the purpose of repair and maintenance at any given time.
  18. CVWD Use Only
  19. Processed By:
  20. COACHELLA VALLEY WATER DISTRICT
    Post Office Box 1058
    Coachella, California 92236
    (760) 391-9600
    (760) 398-3190 - fax
    CustomerService@cvwd.org

    rev 7/2022

  21. Leave This Blank:

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