Application for Water Service

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Email *

APPLICANTS NAME *

SERVICE ADDRESS *

MAILING ADDRESS (if different than service address)Type "same is it is the same. *

MOVE IN DATE (CLOSE OF ESCROW DATE) *

TTTT

OWNER or RENTER *

Owner

Renter

SEND BILL TO EMAIL ADDRESS? *

YES

CELL PHONE NUMBER *

BUSINESS PHONE NUMBER *

LANDLINE PHONE NUMBER *

Owner's signature. Renter's must have owners signature. Please Type in Owners name, then print form and have owner sign, then submit to Trout Gulch Mutual Water Co. 90 Victoria Lane, Aptos, CA 95003. The owner of the property MUST sign the application and by doing so declares that they will be responsible for any charges made against the property if the "renter" vacates the premises, leaving a balance due on the account.

Bills are due and payable on presentation. Rates and charges which are not paid on or before the due date printed on the bill shall be delinquent. A late fee charge will be applied to the account and a delinquent notice will be sent. Significant Past due accounts maybe subject to property liens. I have read and understand the statements above *

YES

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