By my/our signature(s) below, I/we hereby certify the information provided herein and following statements are true and correct:
I/we am/are the owner(s) of the property located at the Service Address listed above [referred to as the "Property Owner" herein].
Property Owner has provided their option to request or decline the installation of a grinder pump system at the Service Address listed above in order to connect the Service Address to the public wastewater system. If requesting connection, Property Owner has chosen the system to be installed by LMUD or the Property Owner as part of the ODWW Project.
Property Owner has read and understands the information provided herein, including the Preliminary Information, Estimated Project Schedule, Connection Options, Fees, and Additional Terms and Conditions.
Property Owner hereby agrees to pay all rates, fees, and charges referred to herein and to comply with the Rate Order, other orders, rules, regulations, codes, and guidelines of LMUD now existing or as may be revised by LMUD in the future in LMUD’s sole discretion. Property Owner further agrees to comply with and be bound by LMUD’s Rate Order, other orders, rules and regulations, policies, guidelines, Water Conservation Plan, and Drought Contingency Plan, as the same may be amended from time to time by LMUD in its sole discretion, and agrees to the imposition and payment of fines and penalties for noncompliance.
This Agreement shall become effective when signed by a duly authorized representative of LMUD.
Before filling out this form, please call Stephanie Threinen at our main office at (512) 261-6222 ext. 175 to confirm your location is eligible to complete this form at this time.
