SPECIAL SERVICE NEEDS OF APPLICANT. The District shall sell and deliver water service to the Applicant and the Applicant shall purchase, receive, and/or reserve service from the District in accordance with the Service Policies of the District, as amended from time to time by the Board of Directors of the District. Upon compliance with said Policies, including payment of a deposit, the Applicant shall become eligible to receive service. The Applicant shall pay the District for service hereunder as determined by the District's Service Policies and upon the terms and conditions set forth therein, a copy of which has been provided as an information packet, for which Applicant acknowledges receipt hereof by execution of this Agreement. A copy of this Agreement shall be executed before service may be provided to the Applicant. The District shall have the authority to discontinue, terminate or suspend the service to any customer not complying with any policy or not paying any utility rates, fees or charges as required by the District's published Service Policies. At any time service is discontinued, terminated or suspended, the District shall not re-establish service unless it has a current, signed copy of this agreement. All water shall be metered by meters to be furnished and installed by the District. The meter connection is for the sole use of the customer and is to provide service to only one (1) dwelling or one (1) business. Extension of pipe(s) to transfer utility service from one property to another, to share, resell, or sub-meter water to any other persons, dwellings, businesses, or property, etc., is prohibited. replacement needed thereafter The District shall have the right to locate a water service meter and the pipe necessary to connect the meter on the Applicant's property at a point to be chosen by the District, and shall have access to its meter and equipment located upon Applicant's premises at all reasonable and necessary times for any purpose connected with or in the furtherance of its business operations, and upon discontinuance of service the District shall have the right to remove any of its equipment from the Applicant's property. The Applicant shall install, at their own expense, any necessary service lines from the District's facilities and equipment to the point of use, including any customer service isolation valves, backflow prevention devices, pressure regulators, clean-outs, and other equipment as may be specified by the District. Upon installation, customer valve and ...
SPECIAL SERVICE NEEDS OF APPLICANT. NOTE: FORM MUST BE COMPLETED BY APPLICANT ONLY. The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname. Check one below: Hispanic or Latino Not Hispanic or Latino Check one or more below: White Black or African American Check one below: Male Female American Indian/Alaska Native Asian Native Hawaiian or another Pacific Islander In accordance with Federal law and the U. S. Department of Agriculture’s policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability (Not all prohibited bases apply to all programs.) To file a complaint of discrimination, write to: USDA, Director, Office of Civil Rights, Room 000-X, Xxxxxxx Building, 14th and Xxxxxxxxxxxx Xxxxxx, XX., Xxxxxxxxxx, XX 00000-0000 or call 000-000-0000 (Voice and TDD). USDA is an equal opportunity provider and employer. Service Application and Agreement AGREEMENT made this day of , , between Culleoka Water Supply Corporation, a corporation organized under the laws of the State of Texas (hereinafter) called the corporation) and _ (hereinafter called the Applicant and/or Member),
SPECIAL SERVICE NEEDS OF APPLICANT. NOTE: FORM MUST BE COMPLETED BY APPLICANT ONLY. A MAP OF SERVICE LOCATION REQUEST MUST BE ATTACHED. The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname. Check one below: Check one or more below: Check one below: Hispanic or Latino White Asian Male Not Hispanic or Latino Black or African American Native Hawaiian or Female American Indian/Alaska Native other Pacific Islander In accordance with Federal law and the U. S. Department of Agriculture’s policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability (Not all prohibited bases apply to all programs.) To file a complaint of discrimination, write to: USDA, Director, Office of Civil Rights, Xxxx 000-X, Xxxxxxx Xxxxxxxx, 14th and Xxxxxxxxxxxx Xxxxxx, XX., Xxxxxxxxxx, XX 00000-0000 or call 202-720- 5964 (Voice and TDD). USDA is an equal opportunity provider and employer. AGREEMENT made this day of , , between Altoga Water Supply Corporation, a corporation organized under the laws of the State of Texas (hereinafter) called the corporation) and (hereinafter called the Applicant and/or Member),
SPECIAL SERVICE NEEDS OF APPLICANT. HOUSEHOLD SIZE LIVESTOCK & NUMBER The following information is requested by the Federal Government, in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application, or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname. NOTE: FORM MUST BE COMPLETED BY APPLICANT ONLY. White Black Race/National Origin (Not of Hispanic Origin) American Indian Hispanic Asian or Or Alaskan Native Pacific Islander Other Male Female EQUAL OPPORTUNITY PROGRAM Sheet 1 of 4 Sheet 2 of 4 Service Application and Agreement AGREEMENT made this day of , 20 , between Starr Water Supply Corporation, a corporation organized under the laws of the State of Texas (hereinafter called the corporation), and (hereinafter called the Applicant and/or Member).
