New Service Request Utility Service Request and Agreement Utility Service Request and Agreement SERVICE INFORMATION Service Address (required) Service Start Date (required) Owner/Tenant (required) Owner Tenant Owners: Upload Settlement Agreement for Owner Verification APPLICANT INFORMATION First Name (required) Last Name (required) Mailing Street or PO Box (required) Mailing City (required) Mailing State (required) Mailing Zip (required) Primary Phone (required) Secondary Phone Email Address (required) * FOR TENANTS ONLY * Upload Lease Agreement Property Management Co or Landlord Phone Number I understand, acknowledge and agree that; (1) I am and shall continue to be bound by the Districts ordinances, resolutions, rules and regulations applicable to cost, control, maintenance, and operations of such Districts utility services; (2) I am personally liable for the prompt and timely payment of all District utility charges incurred for said services; (3) my failure to promptly and timely pay such charges may result, at the District’s option, in the termination of my utility services (in accordance with the procedures of the Utah Code 17b-1-903 (1)(a)), and/or the pursuit by the District of such other enforcement remedies as the District may have at law and/or in equity to enforce the terms of this agreement and the District’s applicable ordinances, resolutions, rules and regulations; (4) whether or not Judicial enforcement is pursued by the District, I shall pay the costs and reasonable attorneys’ fees incurred by the District in connection with collection and/or other enforcement of my obligations, responsibilities, and liabilities hereunder; and (5) the remedies provided herein are cumulative, and the exercise of any other remedy or remedies deemed necessary thereby for the collection of such delinquent amounts. Your Signature (required) Confirm e-Signature Review Electronic Records and Signatures Policy (required)Read our Electronic Record and Signature Disclosure I agree to use electronic records and signatures There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
