Full Text
OFFICE USE ONLY CUSTOMER ID – LOCATION ID: Date Received: Employee Received: _ Person in Laramie to be contacted in case of emergency: CITY OF LARAMIE Administrative Services Department PO BOX C Laramie, Wyoming 82073 PHONE: (307) 721-5222 PHONE: (307) 721-5324 [EMAIL REDACTED] Connection Request Application • Is the water off at this building? If the water is turned off at the address of service, please contact the City of Laramie Utility Billing department at [PHONE REDACTED], Monday through Friday 8am – 5pm. • Is this building under construction? • Is the address of service a: • How many kitchen units are in the building? • Is this location tapped to city water? • Does this location utilize city sewer services? • Is this is a garbage only account? • If Business: 1. Type of business: (grocery, bar, etc.) 2. Will you be utilizing the City of Laramie as your garbage hauler? If yes, select one: Receptacle (if so, ) / Dumpster (if so, size: ) 3. Would you like to be contacted by the City of Laramie Solid Waste division for garbage collection questions and/or quotes for your business? 4. Would you like to set up recycling services for this commercial property? Contact Information (Owner): Owner Property manager Tenant Per City of Laramie's Owner-Only Policy, tenants are not permitted to sign up for city services for residential properties. The account will remain in the owner's name for the duration of the ownership. Property managers can sign up for services in lieu of owner absence with proof of property management agreement. Please see a customer service representative for further information. ---PAGE BREAK--- • Do you wish for us to automatically deduct the amount of your bill from your checking account? YES / NO If you would like this deduction, please fill out the ACH form and attach a voided check. • Do you wish to receive your bill statement via email only? General Information: City services and recycling are billed There is no deposit required; however, base charges for water, sewer, garbage and recycling services, and mosquito control are billed in advance. Water and sewer consumption are billed the following month and are based on actual meter readings. Owner: The Laramie City Code provides that the property owner and/or the agent, tenant, purchaser, and/or lessee of such place of abode or place of business shall each and all be jointly and severally liable for the payment of all charges and fees hereunder. Failure to pay any charges and fees when due shall constitute a violation of the provisions of this chapter. Collection of the charges and fees fixed under this Code when delinquent may be enforced by civil action at law brought by the City and/or accredited collection agency for the City in any court of competent jurisdiction, and this remedy in cumulative and not exclusive and shall be in addition to all penalties provided by this Code for any violation of any provisions hereof. No change of ownership or occupation shall affect the application of the Section. If you elect to have your tenant receive a duplicate bill and they fail to pay the charges in full, you will receive a written notice mailed to you at the mailing address provided on the front side of this form stating that charges have not been paid and that the services may be terminated. If services have been terminated for non-payment, there will be an administrative fee to restore services. Please note: payment responsibilities and arrangements between landlords and tenants constitute a civil agreement to which the City of Laramie is not a party. Ultimately, the property owner is responsible for the utility account. I have read all of the above and fully understand all that I have read. To the best of my knowledge, all the information I have given to you is correct and accurate. I hereby acknowledge that I am the owner of this property and agree to be responsible for payment of municipal services until I notify the City of Laramie Utility Billing Department otherwise. Owner Signature Date Completed forms may be emailed to [EMAIL REDACTED] or dropped off in person at City Hall (406 Ivinson Avenue), or mailed to: City of Laramie – Administrative Services PO Box C Laramie, WY 82073