Start/Stop/Change Service :: Form Types :: Lakeway Municipal Utility District

Note: This form will only be processed if request is made by the current customer(s) at the service address.

I am requesting service to be terminated at the following service address. I understand that I may request any date in the future to terminate service, but I cannot stop service prior to today. If I back-date this request, the District will correct the date to the date it receives the request.
Name*
First Last
Service Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Effective Date*
Date Format: MM slash DD slash YYYY

Selection date must be Monday thru Friday excluding Holidays and (1) business day prior to Today’s Date
Please send my final bill and/or refund to the following address:
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
I am aware that my water, wastewater, and/or reuse service will be terminated at the above service address on the above date between 8:00am and 5:00pm. If I need to change the above date, I understand I am responsible for calling LMUD at 512-261-6222 at least one (1) business day prior to the requested termination date and will submit a new Request for Termination of Service form. I am aware that LMUD will charge a $50.00 service fee to reschedule to another date, reconnect service, or cancel the termination request if I do not notify LMUD at least one (1) business day prior to the requested termination date.
FOR AUTO-DRAFT CUSTOMERS ONLY
- I would like my final bill to be auto-drafted per my method on file as soon as my final bill is available.
If left un-checked we will email and/or mail your final bill as soon as it is available.
Signature
Date
Date Format: MM slash DD slash YYYY
Phone
Email*
If you mail, email or fax this form, it is your responsibility to verify that we received it.

Completing this form does not automatically terminate recurring bank/credit card drafting. To terminate automatic drafting prior to your final bill being drafted, fill out the “Cancel Automatic Drafting” form or contact the District Office. Otherwise, we will remove your automatic drafting once your account has a zero balance.
Comments
This field is for validation purposes and should be left unchanged.

IMPORTANT INFORMATION REGARDING REQUESTS FOR EARLY AND LATE CONNECTIONS*
1. The following non-refundable One-Time Charges must be paid with this Application:
Application Fee	$100
Capacity Reservation Charge	$3,675*
Plumbing Inspection Charge	$225
TOTAL NON-REFUNDABLE ONE-TIME CHARGES FOR EARLY OR LATE CONNECTION REQUESTS	$4,000
*Increased to $3,675 on Jan 1, 2020 and then an additional $125 each year thereafter.
2. 220 volt electricity to support an electrical panel to the grinder pump must be supplied by Property Owner at Property Owner’s sole cost and expense by a licensed professional electrician registered to do business in Texas prior to and as a condition of initiating wastewater service from LMUD through the ODWW Project.

Request Termination of Service

Start/Stop/Change Service

Request Termination of Service

Contract For Installation And Fee Schedule For Out Of District Wastewater Project (ODWW Project) For Lakeway Subdivision, Sections 1 – 17

Purpose and Use:

Property Owner Information:

Estimated Project Schedule:

Connection Options:

Fees:

Additional Terms and Conditions:

Property Owner Certification And Signatures:

Property Owner #1

Property Owner #2

Application and Service Contract for Water and/or Wastewater Services

Date Service is Requested to Begin

Customer Information

Customer #2 Information

Service Address

Billing Address

Payment

Customer Obligations

General Terms of Service

Rates, Fees, and Charges

Easement

Notice of Right of Confidentiality

Customer Certification and Signatures

Lakeway Municipal Utility District

Customer Support

Quality Matters