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CITY OF MIDDLETON WATER UTILITY 7426 HUBBARD AVE MIDDLETON, WI 53562 (608) 821-8370 ● FAX (608) 827-1080 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 thru . I agree to notify the Water Utility when I am no longer the responsible party. 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. Billing Information (please print) Owner Name: Owner Phone Owner Email: Tenant Name: Tenant Phone Tenant Email: Billing Address: City, State, Zip: Service Address: Account Owner’ s Signature Tenant’s Signature