Water Turn-on Waiver – Acceptance of Full Responsibility and Liability Please enable JavaScript in your browser to complete this form. - Step 1 of 2I, the water customer, request variance from LWD regulations that the customer, or designated representative, be in attendance at the time and place of the water service turn-on. The purpose of this regulation is to give the customer the opportunity to ensure that all plumbing is correct and secure, that no leaks exist, and to take responsibility for the turn-on of the water service. Having been informed of the above requirement, and not intending that I (or my representative) will be on site for the water service turn-on, I accept full responsibility and liability for any loss or damage that may result from turn-on of the water. I further acknowledge that if the service is not left on, due to continuous movement on the meter (indicating water flowing continuously on the premises), an additional charge of $25.00 will be applied for the serviceman's second trip to the site if requested by the customer between 8:00 AM and 4:00 PM, or $35.00, if after those hours. Current service call charges approved by Board December 9 2013. Customer Name *Service Turn-on Date *Service Turn-on Time *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateEmail *Phone *NextUpdating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.PreviousSubmit Waiver