RESIDENTIAL UTILITY APPLICANT INFORMATION
PROPERTY OWNER NAME:
Last Name
First Name
Middle Name
(Optional) SECOND OWNER:
Last Name
First Name
Middle Name
PROPERTY ADDRESS:
Street Address
Zipcode
PROPERTY OWNER MAILING ADDRESS:
Street Address
City
State
Zipcode
Driver License Number
DL State
Phone
-
Purchase Date
(example 08/17/2016)
Title Company
Previous Owner's Last Name
Email Address
UTILITY APPLICATION AGREEMENT
I hereby apply and agree to receive the utility services rendered by the City of West Jordan. I agree to abide by the City’s utility service regulations detailed in the Municipal Code Title 9. I agree to pay all charges, fees, interest, and penalties incurred in connection with the City’s rendering such services. I further agree that one or more of these utility services, including water service, may be discontinued when, after notice to me by regular mail, there remains an unpaid balance for any of the utility services furnished by the City.
I understand that utility services will not be commenced or continued at a particular service location if I or my tenant/ occupant at that location is indebted to the City for utility services. If a deposit is required and collected, I consent that upon cancellation of this agreement that all accrued charges may be taken from such deposit, the balance of which shall be refunded to me. I understand it is my responsibility to notify the City of any change in occupancy status and/or billing address.
I understand that before service is commenced or restored I agree to pay all unpaid utility service fees, late charges equal to one and one half percent (1.5%) per month of the unpaid balance which is overdue, including all reconnection costs and reasonable attorney fees incurred to enforce this agreement. I will be responsible for collection fees up to an amount equal the maximum allowed by the State of Utah.
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