APPLICATION FOR SERVICE
52 Winthrop Street, Hallowell, Maine 04347
WWW.HALLOWELL WATER DISTRICT.COM
NAME (owner) DATE
I am requesting WATER service at the above location . yes no
I am requesting SEWER service at the above location . yes no
* I understand that
as the owner, I am responsible for all bills assessed to this location by
the Hallowell Water District.
* I acknowledge receipt of a copy of the water and sewer rates.
* I agree to abide by all the rules, regulations, and policies of the District and I agree to abide by all the applicable rules
and regulations of the State of Maine, Public Utilities Commission. If a conflict arises between the Hallowell Water
District rules about water service issues and the Maine Public Utilities Commission's rules, the Commission rules shall
* I agree to accept service at the pressure and quality available in the area.
* I agree to notify the District of any change in use of the property.
CUSTOMER CLASS : RESIDENTIAL COMMERCIAL % of comercial use
signature (owner) telephone number
IS THIS RENTAL PROPERTY
If "YES" how many units