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APPLICATION FOR WATER and/or SEWER SERVICE Account Number: Work Order # THE UNDERSIGNED OWNER/OWNER'S AGENT OF THE PREMISES AT ADDRESS: hereby applies to the City of Kalispell for Water and/or Sewer Service at said premises. The undersigned agree to abide by all rules, regulations and ordinances of the City relating to Water and/or Sewer Service and to pay for all water/sewer charges therefore. The undersigned owner is aware of and agrees that he will be liable for all water/sewer service charges to said premises, as provided by Section 26-2, Code of the City of Kalispell, Montana. MAIL TO OWNER Print Name: Mail To Address: City: State: Zip: Telephone: Email (optional): Social Security # Drivers License # Date of Birth Remarks: Date Ordered: service: Receive E-Bills: Yes No Signature: Rental Property: Yes No ****ATTENTION APPLICANT**** Application will be returned if any of the above information is missing and will not be submitted until all necessary information is filled out properly. **FOR OFFICE USE ONLY**NOTICE TO DISCONNECT/RECONNECT WATER SERVICE Account # Meter Reading: Owner: Final Requested By: Address: Mail Final to: Date Ordered: Turned Off: By: Due: Turned Off: By: Meter Size Rcv'd by: SN# Signature Date CITY OF KALISPELL P.O. Box 1997 Kalispell, MT 59903 OR