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OWNER – TENANT AGREEMENT FORM CITY OF MIDDLETON - WATER UTILITY 7426 HUBBARD AVE, MIDDLETON, WI 53562 (608) 821-8370 ● FAX (608) 827-1080 [EMAIL REDACTED] Middleton Water & Sewer Utility Billing - Responsible Parties Date Tenant I, , agree to be the responsible party for the water and sewer bills rendered for the property at effective from through . I agree to notify the Water Utility when I am no longer the responsible party. I also understand, per ACT 274, unpaid Utility bill arrears can become a lien on the tenant’s assets with Dane County Courts. Owner As the property owner at I acknowledge that I am ultimately responsible for water and sewer bills rendered for my property, and I further acknowledge that unpaid bills may be placed on my property tax bill for collection. I also acknowledge that I understand that services are not disconnected for non-payment and I will be notified once per quarter of unpaid tenant bills 14 days past due. Per Wis. Stat.66.0809. Billing Information (please print) Owner Name: Owner Phone Owner Email: Billing Address: City, State, Zip: Tenant Name: Tenant Phone Tenant Email: Service Address: Account # : Owner’s Signature Tenant’s Signature