You must provide your full civic address. PO Boxes will not be accepted. Ex. 4220 Smith Street

I grant permission to CityWest or a designated affiliate to enter my property. By checking this box, I also confirm that I am the homeowner of this property. I also understand that this authorization does not commit the property owner to accept CityWest services beyond the installation of the drop.
Yes, I grant permission:

Please type any additional comments here. If you would like to notify us of pre-existing damage or special considerations (such as sprinklers), please type them here.