Kenbridge Town of Kenbridge  New Customer. Application1 for Water/Sewer Service  Applicant Name: Drivers License Number & SSN: Mailing Address:  Property Location/911 Address: Home Phone_ Place of Employment lami interested in: having bille emailed to me.  Cell Phone_  Work Phone_  Email Address:  lwould like to sign upi for auto draft of payment  Applicant: Ihereby understand thet followingi items with regard tot the above referenced property: 1.Thatl lamr responsible for all water and: sewer charges incurred by me ont the above referenced property. 2.That the Town of Kenbridge willl bill me monthly based on my water ands sewage use byt the last day of ther month. 3.That the! bill becomes late on1 the 215t ofe each month and will incura ai 10%1 late penaltyi ifr notp paid.  4.1 That ifthel bill isr not paid! by the 1st of next month, my water will bet turned off and1 there isa a $30r reconnect fee. Payment inf full and 5.1 must notifyt the Town of Kenbridge whenr moving from this address or will be responsiblet for any water usage beyond my move out date. 7.Ifrenting or leasing property, a deposit of $175.00, a water connection fee of $7.50.and: a copy of your lease/rental agreement will be  reconnect fee must be received before services are cut back on. 6.Ac copy ofap photo IDi is required with application.  due before service is activated.  8.1 Tampering witha a waterr meter willr resulti ina a $75.00 penalty fee whichr must be paid before service isi installed.  9.Ifutility bill becomes delinquent, a notice will be sent tot the property owner byr mail.  Applicant Signature  Date  Ifyoud own thep property, no deposit ist required however some form of ownershipi is requiredi ie deed, mortgage statement etc. PROPERTY OWNER- The owner of the property described above understands that should the above applicant fail to paya any monthly water and sewage bills he/she incurs ont this property, the Town of Kenbridge may attach al lien to the property for said  unpaid amounts pursuant to Virginia Code Section 15.2-2118.  Property Owner Signature Phone Number  Date_  Mailing Address  For office use: FMS account #:  Utility on Date:  Meter reading    Town of Kenbridge Property Owner Deposit Waiver Form  Date: Property Owner: Name of Renter:  Physical Address of Rental Property:  By signing the Property Owner Deposit Waiver Form, the property owner agrees to allow the Town of Kenbridge to waive the $175.00 utility deposit for the above named renter. The owner of the property described above understands that should the above applicant fail to pay any monthly water and sewage bills he/she incurs on this property, the Town of Kenbridge may attach a lien toi the property for said  unpaid amounts pursuant to' Virginia Code Section 15.2-2118.  Property Owner Renter  Town Manager