Any person, other than a subdivider or developer seeking multiple connections, who desires or is required to secure a new connection to the municipal water system shall file with the water department for each such connection a written and signed connection application in substantially the following form:

__________, UTAH

APPLICATION FOR WATER CONNECTION

TO THE MUNICIPALITY OF __________

I hereby apply to the municipality of ________ for permission to connect my premises at __________with the municipality of water system and hereby agree as follows:

1. (a) The municipality shall make the requested connection from its water main to and including the water meter and up to my property line or to the meter if the meter is installed within my property. I agree to pay the municipality the connection charges and fees as may be fixed by the governing body by resolution or ordinance including a reservoir charge if so provided.

Additionally, I agree to pay $ __________ for inspection and overhead charges and other miscellaneous costs of the municipality as may be fixed by the governing body by resolution or ordinance.

The work of extending the water connection from the point to which the municipality installs it to the place at which the water is to be used shall be my responsibility and shall be performed at my sole cost.

(b) The connection so made by the municipality, including the meter, shall remain the property of the municipality at all times, and the municipality shall have access thereto at all times.

2. The location of the meter, whether on my premises or at some point near my premises, may be decided solely by the municipality.

3. Before making connection with the water system, I shall cause the plumbing upon my premises to be inspected by the municipality and if the plumbing is not approved, I will cause the plumbing to be rectified at my own expense to meet the requirements of the municipality or of any other governmental agency having jurisdiction to regulate the water system within the municipality.

4. I will be bound by the rules, regulations, resolutions or ordinances enacted now or hereafter by the municipality applicable to the municipality’s water system.

5. The purpose for which the water connection will be used is __________.

6. The municipality shall have free access to the lines and meters installed under this agreement and, at reasonable times, through my property if necessary.

Dated this __________day of __________, 20__________.

__________

(Applicant)