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City of Belgrade 91 E Central Ave Belgrade, Montana 59714 (406) 388-3760 www .ci.belgrade.mt. us PROPERTY OWNER AND RENTER/USER AGREEMENT Account Number: The UNDERSIGNED hereby requests water and sewer service for the following premises and users: User's Name: User's Address: User's Phone Number: USER'S SIGNATURE: DATE: Property Owner's Name: Property Owner's Address: Property Owner's Phone Number: The water and/or sewer bill is to be mailed to _ The UNDERSIGNED, being the owner of the real property described above, hereby makes application for water and sewer services of the real property described above. I agree to comply with and be bound by all ordinances, resolutions and rules of the City of Belgrade now in force or as they may hereafter be amended, all of which are hereby made a part of this contract. If for any reason the above-mentioned user leaves the premises with an unpaid water and sewer bill, I agree as the real property owner to hereby pay any remaining unpaid balance before another user/renter occupies the premises and requests water and sewer service. PROPERTY OWNER'S SIGNATURE: DATE: PLEASE RETURN TO THE CITY OF BELGRADE 91 E CENTRAL A VE BELGRADE MT 59714