New Meter Application

Instructions: Please fill out the online application for new service, make sure you read and understand the “terms of agreement”. Please make sure all information is filled out correctly, then click submit. Please note that applications will NOT be accepted or water service will NOT be turned on without all requested information. Once we receive your application, please allow 24 hours for us to process. Once the application is processed, a customer service clerk will contact you with an amount to pay. That amount will be due at the time of application or be denied.
Today's Date: *

Month/Day/Year
Date of Service Requested: *

Month/Day/Year
Service Address applying for:
(please include lot number)		 *
Subdivision Name:
(if no subdivision leave blank)		 *
 
 
Applicants Name: *
Billing address:
(where you want your billing
statements mailed to)		 *
Primary Phone: *
Secondary Phone:
Email Address: *
Would you like to sign up for Email Billing?                 *
Date of Birth: *

Month/Day/Year
Social Security Number
or Tax Id Number if a business:		 *
Employer (If employed):
Employer Phone:
Emergency Contact Name: *
Emergency Contact Phone: *
Have you ever been an
Etowah Water customer?		                 *
Does your location also
require sewer service?		                 *

Terms of Agreement:

The applicant agrees to the following: I, the customer, agrees to the following: I agree to pay a security deposit of $ _____ and a Water Meter Connection Fee of $____ for a ___-inch water meter. If a meter box is not already existing on the property, I agree to pay a tap and meter fee of $_____. A water meter card will be placed by the customer at the site where the water meter is to be installed by Etowah Water and Sewer Authority, (“Authority”). I agree if I am transferring services a transfer of service fee of $25.00 is due at the time of service. Upon termination of service by the customer and payment of all outstanding charges for services, including any applicable disconnection fees, the security deposit, if collected, will be refunded to the customer without interest. Upon discontinuance of service by the Authority for non-payment of bills after notice to the customer, the security deposit, if collected, will be applied by the Authority toward settlement of the account. Any balance will be refunded to the customer; however, if the security deposit is insufficient to cover the bill, the Authority may proceed to collect the balance as provided by law for the collection of debts.

I understand that the Authority will read the meter monthly and compute usage and bill me monthly for said usage. Usage is measured in gallons. I understand that there is a water base rate billed to all accounts each month based on meter size regardless of water consumption and that there may be an additional water commodity charge based on metered water consumption billed on a per thousand gallon basis. I have been provided with the current rates. I understand that these rates may change from time to time as determined by the Authority’s Board of Directors. I agree to pay the minimum base rate per month and for all water consumed per the water commodity rate as set by the Etowah Board of Directors. I agree to pay all bills for service in a timely manner, in full, on the bill’s due date. However, should I pay my bill late, I agree to pay any late fees, reconnect fee, or returned check fee set by the Etowah Board of Directors.

I understand that if my property is sold or otherwise conveyed to another person or entity, I will notify Etowah Water & Sewer Authority and close my account.

Duly authorized agents of the Authority shall have access at all hours to the premises of the customer for the purpose of installing or removing the Authority’s property, inspecting piping, reading and testing meters, or for any other purpose in connection with the water service and its facilities. If someone other than an Authority employee damages the meter box or its contents, I, the customer, will be held responsible. It is very important for the meter to be in a clear area. I will be responsible to keep any bushes, trees, plants, flowers or any other items located in the meter area trimmed back or removed. If the area becomes an issue, the Authority will notify the customer first. I will have 10 days to correct the issue. If it is not corrected within that time frame, the Authority will remove the items around the meter. The Authority will maintain the water meter, however if damages are caused by the customer, I will be responsible for the damages. I am responsible for maintenance, repair and replacement of any water infrastructure from the meter to my property. Should damage occur to that infrastructure I understand that I am responsible for making needed repairs and the costs associated with the repairs.

If the new account is required to have a backflow prevention device as specified by the Authority’s Backflow Prevention Program – Specifications and Details for Installation of Backflow Assemblies, latest edition, the customer acknowledges that it must comply with Etowah’s Backflow Prevention Program through the installation and replacement of the required backflow device(s). The customer further understands and agrees that the Authority will test and repair, as required, all backflow devices annually by a State Certified Backflow Specialists. I agree o pay a monthly Backflow Prevention Device Maintenance Fee per backflow prevention device, to cover the cost of inspection, testing and repair (but not replacement) of the backflow device. The Authority will provide a minimum of 7 days written notice of its intent to inspect or test. I agree that it is a violation of state law to obtain water or sewer services without paying for them and that it is further a violation to destroy, damage, deface, or otherwise tamper with water or sewer infrastructure, including meters or any piping associated therewith. I further understand that if it is determined by the Authority that there has been unauthorized use, misuse, theft, destruction, damage, defacement or tampering with water or sewer infrastructure owned by the Authority, the customer or any user can and will be required to pay the Authority liquidated damages ranging from $1000 to $5000 (1st violation $1000; 2nd $2500; 3rd $5000) and may have service disconnected and be required to pay a service reconnection fee and an additional deposit.

By receiving service from the Authority, I agree to be bound by the terms and conditions as set forth in this Service Agreement, as it exists on the date I begin service, and as thereafter amended. I further understand that the terms of this Agreement may be modified by the Authority without specific written notice to me. Any such amendments to this Agreement shall be posted on the Authority’s website, and shall become effective upon the date of such posting.

I acknowledge, swear or affirm, and represent that all information provided in this application/agreement is true and that I have authority to legally bind any and all person or entities that are receiving service under this agreement.

***By clicking "Submit", you are accepting the Terms of Agreement***
 
 


 

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