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APPLICATION FOR SERVICE

Allow two business days for processing

 

REAL ESTATE AGENT/BROKER

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APPLICATION FOR SERVICE Allow two business days for processing REAL ESTATE AGENT/BROKER

 
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AGREEMENT

The undersigned certifies they are the owner-lessee-tenant-property manager/realtor of the premises where service is applied for, with lawful authority to sign for this application of utility service, and agrees to pay the applicable rates and abide by the terms and conditions as prescribed by Municipal Ordinance and Utility Tariffs for all present and future utility service. Acceptance of this application by the Municipality of Anchorage constitutes a contract between the Municipality and the applicant. All costs incurred by the Municipality for the collection of any unpaid accounts shall be paid by the applicant.

 

The conditions under which a deposit will be required or waived are set forth in Anchorage Water & Wastewater Utility Tariffs.

 

PLEASE NOTE:  METER ACCESS IS A REQUIREMENT FOR SERVICE; FAILURE TO PROVIDE ACCESS MAY RESULT IN DISCONTINUED SERVICE.

 

I hereby declare that the information provided is true, accurate, and complete to the best of my knowledge and belief, and is voluntarily submitted for the purpose of receiving utility service.  I understand that upon presentation, this application becomes the property of the Municipality.  I also certify that I am eighteen (18) years of age or older.
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AGREEMENT The undersigned certifies they are the owner-lessee-tenant-property manager/realtor of the premises where service is applied for, with lawful authority to sign for this application of utility service, and agrees to pay the applicable rates and abide by the terms and conditions as prescribed by Municipal Ordinance and Utility Tariffs for all present and future utility service. Acceptance of this application by the Municipality of Anchorage constitutes a contract between the Municipality and the applicant. All costs incurred by the Municipality for the collection of any unpaid accounts shall be paid by the applicant. The conditions under which a deposit will be required or waived are set forth in Anchorage Water & Wastewater Utility Tariffs. PLEASE NOTE: METER ACCESS IS A REQUIREMENT FOR SERVICE; FAILURE TO PROVIDE ACCESS MAY RESULT IN DISCONTINUED SERVICE. I hereby declare that the information provided is true, accurate, and complete to the best of my knowledge and belief, and is voluntarily submitted for the purpose of receiving utility service. I understand that upon presentation, this application becomes the property of the Municipality. I also certify that I am eighteen (18) years of age or older.
 

STATE OF ALASKA                  )

                                                     ) SS:

THIRD JUDICIAL DISTRICT)

THIS IS TO CERTIFY, that on the ________ day of _______________________, 20________, before me the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared _____________________________________________, known to me (or satisfactorily proven) to be the person described herein and who acknowledged to me that they signed and sealed the foregoing instrument in their official capacity, freely and voluntarily, for the uses and purposes therein mentioned.

IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above written.

 

 

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My Commission Expires: ________________________________
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