Luttrell Blaine Utility District
P.O. Box 238 Luttrell, TN 37779 865-992-8611
CONTRACT FOR NEW SERVICE
It is the policy of LBC UTILITY to require that the applicant seeking service be the responsible party residing at the service address. Anyone seeking service who is acting on the applicant’s behalf may be required by the UTILITY to provide the applicant’s written verification as well as applicant’s identification papers, as required below.
Whenever an application is made for service and the UTILITY has knowledge of a dispute as to the ownership of the right of occupancy at the service address, and one or more of the claimants attempts to prevent such service being furnished, the UTILITY reserves the right to adopt either one of the following two courses:
- a) Treat the applicant in actual possession of the premises at the service address as being entitled to such service, notwithstanding the rights or claims of other persons;
- b) Withhold service pending a judicial or other settlement of the rights of the various claimants.
THIS AGREEMENT, entered into by and between LBC Utility District of Union County, Tennessee, a UTILITY established and existing under the laws of the State of Tennessee, hereinafter referred to as the “UTILITY,” and the applicant, hereinafter referred to as “CUSTOMER”:
Applicant Name: _________________________________Spouse: ______________________________________
Street/911 Address (for service): _____________________________City: ____________Zip_________________
Billing Address (if different): _________________________________ City: ___________Zip_________________
Home Phone No.: ______________________ Cell Phone: ___________________________
Emergency Contact Name:_________________________Phone:______________________________
Check One: Applicant is: Owner ______ Renter _____ Other _________________
Check One: Service Type: Single Family _____ Multi-family ______ Business _____ Tax Exempt: ____ (Provide Certificate)
Is there any medical reason that service cannot be interrupted? (Yes) ___ (No) ___
(Written verification from a medical doctor is required before meter can be labeled as non-cut-off. The water bill is still required to be paid in full, but notification will be made prior to disconnect.)
Racial/Ethnic Heritage (Please Check One)
Caucasian______ African American ____ Hispanic____ Asian/Pacific_____ American Indian/Eskimo_____
Other _________
The meters will be read at the end of each month. Bills will be mailed to customers around the 23rd of each month. Bills can be paid without penalty until the 10th of each month, after the 10th a 10% penalty will be added to the bill. Accounts not paid in full by the 20th of each month shall be subject to be discontinued (cutoff) without additional notice. The bill must be paid “IN FULL”, plus a fee of $25 will be charged for reconnection during normal business hours and $50 after business hours.
All applicants requesting the installation of a new tap or the activation of a existing tap, not previously activated Shall be required to pay the utilities monthly minimum bill for a period of 1 Year. Failure to pay said monthly bill for a period of (3) three months may result in the tap being de-activated to the property and water being no longer available to said property until a new tap fee is paid at the current rate charge by the utility.
FEES PAID: TAP FEE______ SERVICE CHARGE______TOTAL COLLECTED__________ Date: ___________
PAYMENT TYPE: CHECK #____________ CASH___________________________ Other ________________
ACCOUNT # ____________ SERIAL # _____________________ MOD # 01-________________________
READING_________________________