Gas and Water Service Disconnect Request Form

If demolishing your building, this form must be accompanied by a Demolition Tracking Sheet for authority sign off. This form must be completed in full and submitted with this application a minimum of 30 days prior to disconnect.

Note:

Kitchener Utilities reserves the right to deny this request if property is not vacant upon arrival. Kitchener Utilities will not sign off on the Building Division’s Demolition Tracking Sheet until both water and gas services have been disconnected.

Gas

There will be a charge for the gas abandonment.

Water

Visit City of Kitchener Budget for applicable fee schedule.

Property Owner Details

Date range for gas/water to be shut off: (Provide a 10 day window)

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Allowed extensions pdf, doc, jpg, jpeg,

Personal information is being collected under the authority of s. 28(2) of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and will be used to collect information for water/gas disconection services. This information will be shared with staff who require it for their work as part of Kitchener Utilities and will be stored on a server owned by a Third Party Service Provider (eSolutions Group) located in Canada. The personal information collected herein will be used only for the purposes relating to the program and will be protected in accordance with the requirements stipulated in the MFIPPA. 

Inquiries about the collection, use or disclosure of your personal information should be directed to the Business Development and Conservation Strategist, 131 Goodrich Drive, Kitchener, Ontario, N2C 2E8, (519) 741-2600 ext.4214.



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