Application And Agreement For Utility Services - Bonney Lake, Washington
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19002 Main Street East
PO Box 7380, Bonney Lake, WA 98391
Phone: (253) 447-4317 Fax: (253) 862-8538
Website:
Application and Agreement for Utility Services
OWNER’S NAME: _____________________________ HOME PHONE # ________________________
CELL PHONE # _______________________________ WORK PHONE # ________________________
SERVICE LOCATION: _________________________________________________________________
CLOSING DATE: ________________________
MAILING ADDRESS (If different than service location): _______________________________________
_______________________________________
City of Bonney Lake accounts are maintained in the name of the property owner, requests for changes to account
information must be made by the property owner. Whereas the City has set controls to prevent identity theft, proof of
identification is required for any name or mailing address changes.
DRIVERS LICENSE #__________________________ STATE: _______
DRIVERS LICENSE #__________________________ STATE: _______
The undersigned, referred to as Owner hereby applies for utility services from City of Bonney Lake. In consideration of the City
accepting this request and providing the services, the Owner agrees as follows:
1. The Owner agrees to pay for the services provided in accordance with the rates now in effect or as subsequently increased or
decreased by Ordinance or Resolution.
2. In the event of disconnection (water shut-off) due to delinquency, all charges plus a $100.00 reconnection fee must be paid to
restore service. The Owner will be notified no less than ten days prior to termination of service by written notice sent to the mailing
address.
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3. Utility charges are due upon receipt and become delinquent on the 15
of the month following the billing. A penalty of 2% is
added to all delinquencies. Disconnection is scheduled 30 days after the date of delinquency.
4. The City reserves the right to require cash to redeem any check returned by the bank for any reason.
5. The Owner will provide the City with an accurate mailing address for bills. The city will also mail bills to the Owner’s tenant, or to a
property management company ($45 set up fee each request), provided however that the Owner is always liable for payment of the
charges incurred at the premises, whether occupied in person by the Owner or by tenants.
6. The Owner will keep the meter or meters accessible at all times. The Owner agrees to pay for all damage to the meter which may
occur through the act of negligence of the Owner. The Owner is solely responsible for the maintenance of all pipes located on the
Owner’s property.
OWNER’S SIGNATURE: ____________________________________________ DATE: ____________
(
Transfer of Ownership Fee: $35.00)
For Office Use
Utility Account # __________________________
Indicate Property Type: □ Single Family Residential □ Multifamily Residential □ Commercial
Identity Verified By: _____________________ Date: ___________________
Updated March 2013
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