Application For Connect & Cross Connection Control Survey

The undersigned hereby makes application to the Board of Commissioners of Public Utility District No. 1 of Skamania County (PUD) for one ‘right to connect’ to the Carson or Underwood Water System in accordance with the Carson and Underwood Water System Rate Schedules, at the above described real property.

I understand that I am requesting to purchase a ‘right to connect’ to the Carson or Underwood Water System, and that I will be responsible for all costs to make such physical connection, including but not limited to; the costs of setting the meter, and such system improvements as may be necessary.

I also understand that when payment of the connect is made, a water meter will be installed within 45 business days and upon installation of the physical connection and setting of the meter, I will be responsible for the monthly billing as a regular customer of the Carson or Underwood Water System, and will be subject to all the rules, regulations, and policies of the PUD.