FORMS

Application for Water and Sanitary Sewer Service

DOUGLASVILLE-DOUGLAS COUNTY WATER AND SEWER AUTHORITY

APPLICATION FORM FOR WATER AND SANITARY SEWER SERVICE

APPLICATION FOR WATER AND/OR SANITARY SEWER SERVICE

Name

Date of Birth

Social Security Number

Phone

Applicant is

Service Requested Date

Service Address

Address Line 1

City

State

Zip Code

Date Address?

Is the Mailing Address different than the Service Address?

AGREEMENT FOR WATER AND/OR SANITARY SEWER SERVICE

SECTION 1 - COMPLIANCE WITH AUTHORITY RULES

1.1 The Customer agrees to adhere to and be bound by the Authority’s Rules and Regulation governing use of the utility system owned and operated by the Authority, as such rules now exist or may be amended from time to time.
1.2 The Customer acknowledges that a complete copy of the Authority’s Rules and Regulation is available for purchase or review in the lobby of the Authority Administration Office, located at 8763 Hospital Drive, Douglasville, Georgia, and on the Authority’s website at www.ddcwsa.com.
1.3 The Customer understands that certain Rules and Regulations adopted by the Authority regulate, control, and promote the reduction and/or elimination of both point and non-point sources of pollution. The Customer agrees to comply with all such Rules and Regulation and hereby authorizes the Authority, its agents, servants, and employees to come onto the property during reasonable hours for performing inspections.
1.4 The Customer understands that septic tanks and absorption fields shall be constructed in accordance with County Health Department standards and the Authority’s Design and Construction Standards. The customer agrees that septic tanks in the Dog River drainage basin shall be properly pumped no less than once every five (5) years, and proof of pumping must be made available to the Authority upon request.
1.5 The Customer understands that the Authority commences water service at the meter. The Authority strongly recommends that the Customer be present at the location when the service is turned on (or restored) to reduce the risk of any internal or external damage. The Customer is responsible for maintaining all plumbing and fixtures on the Customer’s side of the meter and assumes all responsibility for any damage on or to the property (including the interior of any structure on the premises) once service commences or is restored.

SECTION 2 - MISCELLANEOUS

2.1 This agreement constitutes the entire Agreement of the parties with respect to the matters set forth herein, and no prior or contemporaneous oral or written agreement shall be deemed to modify or vary the terms hereof.
2.2 This Agreement shall not be assignable by any party hereto.
2.3 This Agreement shall inure to the benefit of and be binding upon the parties thereto and any successor entity into which it may be merged or formed.
2.4 No provision of this Agreement may be amended, waived, or otherwise modified without prior written consent of the Authority.
2.5 This Agreement may be stored electronically and any electronic copy, including the signatures thereto, shall be deemed an original, admissible, and enforceable to the same extent as a paper original.
2.6 This Agreement shall be governed by and construed in accordance with the laws of the State of Georgia.
2.7 An application fee of $25.00 will be assessed on the Customer’s first bill for each new account established.

Application for Water and Sanitary Sewer Service

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APPLICATION FORM FOR WATER AND SANITARY SEWER SERVICE

APPLICATION FOR WATER AND/OR SANITARY SEWER SERVICE

AGREEMENT FOR WATER AND/OR SANITARY SEWER SERVICE

SECTION 1 - COMPLIANCE WITH AUTHORITY RULES

SECTION 2 - MISCELLANEOUS