DRAPER CITY
APPLICATION FOR WATER CONNECTION
(PLEASE PRINT)
Today's Date:
Contractor's Name:
Name of Applicant:
Spouses Name:
Address of Property to be Serviced:
Telephone #:
Lot #
Subdivision:
Service Start Date:
Mailing Address:
Zip Code:
Is the Applicant the Owner?
Purpose for the Water Connection?
Type of Connection Requested: Residential
Commercial Industrial
Number of Connections Requested:
Size of Connections:
Driver's License #:
Date of Birth:
Place of Employment:
Work Phone #
Friend or Relative:
Phone # of Above:
Address of Above:
I hereby apply to the City of Draper for permission to connect the property listed above to the Draper City Water System and hereby agree as follows:
(1) The connection so made by the City at my request, including the meter, shall remain the property of the City at all times and the City shall have free and unrestricted access thereto at all times, together with the right to enter upon my property to make repairs, inspections or replacements as may be necessary.
(2) The location of the meter, whether on my property or at some point near my property, shall be decided solely by the City at its absolute discretion.
(3) I hereby agree to pay all water fees and service charges before or on the 20th of the month. It is understood that if the utility bill becomes 45 days or more delinquent, or if a delinquent charge comes to exceed $40.00, the service will be turned off, and in order for services to be restored, the delinquent bill will be paid and a reconnection fee charged.
(4) I hereby agree to notify City of termination of service.
(5) I agree to permit the City, its agents or employees, to enter the property at the address shown above at all reasonable times for the purposes necessary to rendering of such service. I agree to make certain that the meters and related equipment are readily accessible to the City and that there are no barriers or animals which would prevent reasonable access.
(6) The applicant hereby represents that applicant is the owner of the property for which this application is being submitted to the City. In the event Owner rents or leases or otherwise allows occupancy of Owner's property by any person, owner shall be responsible to the City for payment of all water fees and service charges incurred by that connection on the premises covered by this application. The City may terminate water service in the event owner fails to pay any service charges or fees incurred by a renter or lessee or other occupant. Owner further agrees that any delinquent charges may be transferred, at the City's option, to any other existing or newly established account in the name of the Owner with the City and that such delinquent charges shall be paid by the Owner through the account to which they are transferred. All payments of any delinquent charges from other accounts shall be in addition to any charges incurred by the Owner or those persons renting or leasing from the Owner under the accounts to which the delinquent charges have been transferred.
(7) I hereby agree to pay reasonable attorney fees and costs incurred by the City in collecting delinquent charges for water service.
(8) I agree to pay 11/2% per month on any delinquent amount. The minimum penalty will be listed on the fee schedule.
(9) Any notices which are to be given to owner shall be sufficient if mailed to owner at the address listed on this application.
(10) I hereby agree to hold the City harmless for any loss, damage, or injury caused by or arising out of any defect in the water meter, water meter box, the connection applied for, or any other part of the City water system.
(11) I will obey and abide by all ordinances, rules and regulations now or hereafter promulgated or enacted by the City of Draper and applicable to the City's water system.
DATED this day of , 19 .
Owner's Signature
Witness:
(1994 Code)