Please complete this form if you are the owner of the property being disconnected.
*Please note: if this disconnection request is associated with the demolition of a building, a completed Demolition Tracking Sheet must be submitted with your application. To help ensure all municipal requirements are met, demolition forms, checklists, and related resources are available for download from the applicable municipality using the links below.
City of Waterloo – Demolition forms and requirements:
Township of Woolwich – Building and demolition resources:
City of Kitchener – Demolition and building permit forms:
Township of Wilmot – Demolition permit requirements and forms:
Disconnection Authorization Form
Please complete this form to submit your request for disconnection