Application for Water and Sewer Connection  Account Number  CITY OF COVINGTON, VA.  19  Water & Sewer Utility Department  Application is hereby made by the undersigned to the City of Covington, Virginia to connect with its  WATER-SEWER lines the WATER-SEWER lines of the property located at:  Residential or Business* Number of Persons Number of Apartments Inside Outside  Numberof Water Closets Numberof Trailers City Limits  which property is owned by  The applicant agrees to pay fora  Water and  Sewer connection to be made by the  City of Covington, to be used on the above premises, upon the terms and conditions provided in the Code of The applicant further agrees to pay for all water furnished said premises at the rate now or hereafter established, and all sewer charges assessed against the said premises in accordance with the City, ordinances The: applicant recognizes the City's right to discontinue at any time the furnishing of water and Vor sewer service ifbills are not paid at the proper time, or for violation ofany rule governing water and sewer  City Ordinances.  governing sewer charges.  service. APPROVED:  Superintendent  Owner  Application taken by  Water & Sewer Utility Department  Connection Charge:  Water Sewer Total  NOTE: Allcommercial connections will require thei installation of water meters tol be paid forl by applicant  on a time and material basis.  CUSTOMERSCOPY