Service Application – Owner

Easy and Convenient

 
Opening Times
Monday – Friday:
08:00am – 4:30pm
 
Our Location
P.O. Box 56
1119 W Spring Street Brownstown, IN 47220
 
Customer Service
Phone: (812) 358-3654

Owner Application

Owner Application
Membership (You are required to hold a membership.)
Meter Status
Member Name
Member Name
First
Last
Type your Drivers License Number exactly as it appears on your Drivers License
Co-Applicant
Co-Member Name
Co-Member Name
First
Last
Type your Drivers License Number exactly as it appears on your Drivers License

Maximum file size: 62.91MB

Maximum file size: 62.91MB

Receive Bills via Email
Mailing Address is same as Property Service Address
Other Mailing Address
Other Mailing Address
City
State/Province
Zip/Postal
Your Previous Address
Your Previous Address
City
State/Province
Zip/Postal
INFORMATION FOR GOVERNMENT MONITORING PURPOSES

The information requested by the Federal Government in order to monitor compliance with the Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish, we are required to note the race/ national origin of individual applicants on the basis of visual observation or surname.

Decline:
Gender:
Ethnicity:
Race:
Confirmation and Tariff Acknowledgement
WATER USER’S AGREEMENT OF
JACKSON COUNTY WATER UTILITY, INC.

This Water User’s Agreement (hereinafter the “Agreement”), between the Jackson County Water Utility, Inc., a non-profit corporation, organized and existing under the laws of the State of Indiana, (hereinafter called the “Supplier”); and the undersigned who is a Member of the Supplier, (hereinafter called the “User”):
WHEREAS, the User desires to purchase water from the Supplier, and to enter into the Agreement as required by the Bylaws of the Supplier.

NOW THEREFORE, in consideration of the mutual promises and covenants contained herein, it is hereby understood and agreed by the parties hereto as follows:

The Supplier shall furnish; subject to the terms of Supplier’s rules, regulations, tariffs and policies as amended from time to time; such quantity of water for domestic and farmstead purposes but not for resale, as the User may desire for the following previously described property.

The User shall install and maintain at his/her own expense a service line which shall connect with the distribution system of the Supplier at the place as determined by the Supplier, provided the Supplier has determined in advance that the Supplier’s distribution system has sufficient capacity to permit delivery of water at that point. No part of the User’s service line to, or within, the User’s premises shall be connected with any source of water other than the Supplier’s distribution system.

The User agrees to comply with and be bound by the Supplier’s Articles of Incorporation and Bylaws now in force or as hereafter duly amended, and shall pay for such water; at such rates and charges; and at the time and place; as shall be determined by the Supplier through the Supplier’s rules, regulations or tariffs, as amended.

The User agrees to provide the Supplier without charge such easements, licenses and rights-of­-way as may be required by the Supplier for the purpose of installing, maintaining, removing, or relocating Supplier’s water distribution system as the Supplier may require. If the User is not the owner of the property for which he/she desires service, then the User shall use his/her best efforts to obtain such easement, license, and right-of-way as the Supplier requires from the property owner. Failure by the User to obtain such easements, licenses, and rights-of-way as required by the Supplier shall cause this User’s agreement to be null and void.

The Supplier shall install a cutoff valve and water meter. The User shall also install and maintain a private cutoff valve on the User’s side of the meter, for each service line. The Supplier’s cutoff valve and meter shall be installed at a point agreed upon between the User and the Supplier. The Supplier shall retain ownership of, and have the exclusive right to use such cutoff valve and water meter including turning the same on and off.

The Supplier shall have final authority on any question of location of any service line connecting to its distribution system. The Supplier shall also have final authority to determine the allocation of water to User in the event of any anticipated water shortage including, without limitation, the hours of use or purpose of use to which the User is entitled.

The failure of a User to timely pay all water charges duly imposed shall result in the imposition of interest and penalties as described in Supplier’s rules, regulations, or tariff, as amended.

In the event that any paragraph of this agreement shall be determined by a court of law having jurisdiction over the Supplier to be invalid or unenforceable, the remaining paragraphs of this agreement shall remain in full force and effect.

IN WITNESS WHEREOF, we have hereunto executed this agreement this:

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