Application for the use of water shall be substantially in the following form:

CITY OF GIG HARBOR

WATER SERVICE APPLICATION

Date: ____________

Application is hereby made by the undersigned property owner for water service in the following amount: ________________ at the following location: ______________ _______________________, Gig Harbor, Washington, for the following purposes: ____________________________________, for which I agree to pay in advance the following estimated charges, the exact charges shall be paid as established by City Resolution, and will be determined at the time a water availability certificate issues and be payable immediately upon completion of the installation:

Engineering Fees:     

Water Main Extension:     

Fire Hydrant Installation:     

Street Repair:     

Tap-In Charges:     

Water Service Connection Charge:     

(Metering Charges):     

TOTAL:    $    

I further agree that all rates and charges for water service to the above property shall be paid in accordance with the now-existing ordinances and regulations of the City, or any ordinances and regulations passed hereafter.

I understand that the City will use all reasonable effort to maintain uninterrupted service, but reserves the right to shut off the water at any time without notice for repairs, expansions, nonpayment of rates or any other reason and assumes no liability for any damage as a result of interruption of service from any cause whatsoever.

I understand that if the City issues a water availability certificate to me, such certificate shall be subject to all ordinances and regulations of the city, as they now exist or may hereafter be amended, and that such certificate expires within three (3) years from the date of issuance, if I do not pay the required fees and request an actual hook-up or connection to the below-identified individual parcel of property within this time period, a water availability certificate may be revoked.