HAMLET OF WOKING, SADDLE HILLS COUNTY
Woking Utility Connection
FOR OWNER & RENTER
ACCOUNT CLASSIFICATION: Commercial / Residential
ACCOUNT NUMBER: ___________________
OWNERS’ NAME:
ADDRESS:
LEGAL ADDRESS:
RENTER’S NAME:
ADDRESS:
TELEPHONE # (Owner):
(Renter):
GARBAGE BIN FEE: _____________
GARBAGE BIN SERIAL #: ______________________
CONDITION OF GARBAGE BIN ON SITE: __________________________________________________________
HOOK UP FEE:
RECEIPT #:
The owner acknowledges that they are responsible:
(i)
for notifying the County Office of any change in residence/address, and
(ii)
for not misusing or appropriating County property, and
(iii)
if renting out property, for notifying the County office of change in renters, and
(iv)
being responsible for any outstanding balances incurred by renter, and
(v)
having any outstanding balances applied to the property tax roll, and
(vi)
any variance in the meter reading after disconnection until the next hook up, and
(vii)
for damage and costs to repair damage to water meter both internal and external remote, and
(viii)
for paying garbage bin fees prior to service connection, and
(ix)
accept Saddle Hills County Bylaw & Policy on Water / Sewer services (attached)
initial
Owner’s Signature Date
The renter acknowledges that they are responsible:
(i)
for notifying the County Office of any change in address, and
(ii)
for payment of utility & garbage fees incurred during term of rent
(iii)
for not misusing or appropriating County property, and
(iv)
for paying garbage bin fees prior to service connection, and
(v)
accept Saddle Hills County Bylaw & Policy on Water/Sewer services (attached)
Office Use:
Renter’s Signature
Date
SHC Representative
Date
Water Meter Reading at time of Connection:
Date
Water Meter Reading at time of Disconnection:
Date
Development Officer, Saddle Hills County
Date
All hook-ups require Development Officer Approval
All hook-ups with renters must have owner’s Signature
initial