SUBSCRIPTION FOR AVAILABILITY OF WATER SERVICE
_________________________________________________________________________
NAME OF DEVELOPMENT OWNER OR UTILITY
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
NAME AND LOCATION OF SUBDIVISION
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
NAME AND ADDRESS OF SUBSCRIBER
DOLLAR AMOUNT OF PROPOSED AVAILABILITY RATE
NOTICE
IMPORTANT DISCLOSURE
READ CAREFULLY
1. Subscriber hereby makes application for water service for the following lot(s) in
_________________________________________________________________________________
(subdivision)
Description of lot(s): _________________________________________________________________________
__________________________________________________________________(lot numbers) (street numbers)
2. Subscriber hereby agrees to pay an availability rate for availability of water service as defined herein. The initial availability rate to be proposed by Developer or Utility is $ ___. per __________. (month) (quarter) (year).
3. Subscriber hereby agrees to pay the tap fee or other fees described below in order to receive regular water user service instead of availability service as follows:
______________________________________________________________________________________________
______________________________________________________________________________________________
(fee description and amount)
4. All availability rates, fees, rules and regulations for availability of water service are subject to change from time to time upon approval by the North Carolina Utilities Commission.
5. An "availability rate" shall mean a fee or charge paid to a water utility by a subscriber thereof for the availability of water service being provided by the utility in a specific subdivision or development.
6. "Availability of water service" shall mean that water of adequate quantity, quality, and pressure is available at all times in a water main located within 75 feet of the boundary of the subscriber's property served, or such other distance as the Commission deems reasonable, whether or not water is actually taken from the system by the subscriber, and whether or not a service outlet is located inside the boundary of the property served.
7. The availability rate for water service shall continue to be applicable to the subscriber even if at some time in the future the subscriber's property should no longer be in use and the water service should no longer be required by the subscriber. The subscriber, however, shall not be required to pay the availability rate during such time that the regular water user rates are in force for the subscriber's property.
CERTIFICATION
I have read the above disclosure and understand that I am agreeing to pay an availability rate for the availability of water service to my lot(s), whether or not I use my lot(s).
_______________________________
Signature of Subscriber(s)
_______________________________
Name and Address of Subscriber(s)
_______________________________
Date
_______________________________
Witness
_______________________________
Date Accepted
SUBSCRIPTION FOR AVAILABILITY OF SEWER SERVICE
NAME OF DEVELOPMENT OWNER OR UTILITY
NAME AND LOCATION OF SUBDIVISION
NAME AND ADDRESS OF SUBSCRIBER
DOLLAR AMOUNT OF PROPOSED AVAILABILITY RATE
NOTICE
IMPORTANT DISCLOSURE
READ CAREFULLY
________________________________________________________________________________(subdivision)
Descript of lots(s):____________________________________________________________________________
___________________________________________________________________(lot numbers) (street numbers)
initial availability rate to be proposed by Developer or Utility is $ ____ per __________ (month) (quarter) (year).
_____________________________________________________________________(fee description and amount)
CERTIFICATION
I have read the above disclosure and understand that I am agreeing to pay an availability rate for the availability of sewer service to my lot(s), whether or not I use my lot(s).
_____________________________________
Signature of Subscriber(s)
_____________________________________
Name and Address of Subscriber(s)
_____________________________________
Date
____________________________________
Witness
____________________________________
Date Accepted
SUBSCRIPTION FOR AVAILABILITY OF WATER AND SEWER SERVICE
NAME OF DEVELOPMENT OWNER OR UTILITY
NAME AND LOCATION OF SUBDIVISION
NAME AND ADDRESS OF SUBSCRIBER
DOLLAR AMOUNT OF PROPOSED AVAILABILITY RATE
NOTICE
IMPORTANT DISCLOSURE
READ CAREFULLY
________________________________________________________________________________(subdivision)
Description of lot(s):__________________________________________________________________________
___________________________________________________________________(lot numbers) (street numbers)
_____________________________________________________________________(fee description and amount)
CERTIFICATION
I have read the above disclosure and understand that I am agreeing to pay an availability rate for the availability of water and sewer service to my lot(s), whether or not I use my lot(s).
________________________________________
Signature of Subscriber(s)
________________________________________
Name and Address of Subscriber(s)
________________________________________
Date
_____________________________________
Witness
_____________________________________
Date Accepted
N.C. Admin. Code tit. 04, ch. 11, ch. 7, app 11 R07