Beaver Creek WCID 1 | New Service Application

According to the District’s rate order, an application for water service is required for all new connections.

Please complete and submit the application below.

Fees

Deposit for property owners: $100.00 (refundable, added to first month’s bill) If account is established prior to March 1, 2023 the deposit will be reduced to $50.00.
Deposit for property renters: $150.00 (refundable, added to first month’s bill).
Connection fee: $30.00 (non-refundable, added to first month’s bill).

Request for New Service

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Today's Date

Requested Activation Date(Required)

Address(Required)

Street Address Line 2 City State ZIP Code

Primary Customer

Customer Type(Required)

Name(Required)

First Last

Email(Required)

Phone Number(Required)

Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Employer

Work Phone

Birthday

Social Security # or Tax ID

Optional

Driver's License #(Required)

Driver's License State(Required)

State

Attach an image of a valid, government-issued photo ID which includes your date of birth.(Required)

Max. file size: 20 MB.

Will there be a secondary customer on this account?(Required)

Secondary Customer

Name(Required)

First Last

Birthday

Social Security Number or Tax ID

Optional

Driver's License #(Required)

Driver's License State(Required)

State

Landlord

Name(Required)

First Last

Contact Number(Required)

Address

Street Address Address Line 2 City State ZIP Code

Acknowledgements and Approvals

Service Agreement Exhibit B(Required)

I. PURPOSE: BEAVER CREEK WCID 1 (hereinafter referred to as the “District”) is responsible for protecting the drinking water supply from contamination or pollution, which could result from improper plumbing practices. The purpose of this Service Agreement is to notify each customer of the plumbing restrictions, which are in place to provide this protection. The District enforces these restrictions to ensure the public health and welfare. Each customer must sign this agreement before the District will begin service. In addition, when service to an existing connection has been suspended or terminated, the District will not re-establish service unless it has a signed copy of this Service Agreement.

II. PLUMBING RESTRICTIONS: The following unacceptable plumbing practices are prohibited by State Regulations.

No direct connection between the public drinking water supply and a potential source of contamination is permitted. Potential sources of contamination shall be isolated from the public water system by an air-gap, or an appropriate backflow prevention device in accordance with state plumbing regulations. Additionally, all pressure release valves and thermal expansion devices shall be in compliance with state plumbing codes.
No cross-connection between the public drinking water supply and a private water system is permitted. These potential threats to the public drinking water supply are not permitted.
No connection, which allows water to be returned to the public drinking water supply, is permitted.
No pipe or pipe fitting installed on or after January 4, 2014, which contains more than 0.25% lead may be used for the installation or repair of plumbing at any connection which provides water for human use.
No solder or flux, which contains more than 0.2% lead, can be used for the installation or repair of plumbing at any connection on or after July 1, 1988, which provides water for human use.
No plumbing fixture shall be installed which is not in compliance with a state approved plumbing code.

III. SERVICE AGREEMENT: The following are the terms of the service agreement between the District and the Customer.

The District will maintain a copy of this agreement as long as the Customer and/or the premises is connected to the District’s water system.
The Customer shall allow his property to be inspected for possible cross-connections and other unacceptable plumbing practices. These inspections shall be conducted during the District’s normal business hours.
The District shall notify the Customer in writing of any cross-connection or other unacceptable plumbing practice which has been identified during the initial inspection or the periodic re-inspection.
The customer shall immediately correct any unacceptable plumbing practice on his/her premises.
The customer shall, at his/her expense, properly install, test, and maintain any backflow prevention device required by the District. Copies of all testing and maintenance records shall be provided to the District.

ENFORCEMENT: If the customer fails to comply with the terms of this Service Agreement, the District shall, at its option, either terminate service or properly install, test, and maintain an appropriate backflow prevention device at the service connection. Any expenses associated with the enforcement of this Service Agreement shall be billed to the Customer.

I agree to the Service Agreement.

Right to Confidentiality of Personal Information(Required)

House bill 872, effective September 1, 2021, requires utility companies to notify customers of their right to confidentiality. You are hereby informed that your billing information and personal records are kept confidential unless you request in writing that they become accessible to the public.

“Personal Information” as defined by this notice means an individual’s address, telephone number and social security number.
“Billing Information” as defined by this notice means any information relating to the volume, units of utility usage, or the amounts billed to or collected from the individual for utility usage.

If you have any questions, please contact the District at 281-367-5511.

I acknowledge the Right to Confidentiality of Personal Information.

Make my billing/personal information available to the public.(Required)

No

Yes

Permission to Turn On Water(Required)

I give my permission for Municipal Operations to turn water on at the address above without anyone present. I understand that the District and Municipal Operations & Consulting will not be held responsible for any damage to broken pipes, leaking pipes, flooded areas, or any water related damages etc.

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