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Water Information Request for the TOWN OF MONUMENT FROM: STREET ADDRESS: COMPANY: _ SELLERS NAME: ADDRESS: BUYERS NAME: PHONE CLOSING DATE: E-MAIL:___ TAX SCHEDULE ID Billing Information: Current/Past Due Owing: Pro-Rate: From to ESTIMATE ONLY Total Balance Due: IF CLOSING DATE CHANGES, PLEASE ADVISE FOR REVISED INFORMATION. Town Representative I, , owner of the above named property give the Town of Monument permission to release the necessary billing information to the requestor. Current Owner Signature Note to SELLER: Please contact Town of Monument Water Office to fill out a Water Disconnect form. Note to BUYER: Please contact Town of Monument Water Office with a copy of your Warranty Deed and fill out a Water Connect form. Town of Monument Water Department - Margo 645 Beacon Lite Road Monument, CO 80132 [EMAIL REDACTED] [PHONE REDACTED] phone SIGN