Fill in Water/Sewer Connection Affidavit

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Water/Sewer Connection Affidavit

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WATER / SEWER CONNECTION AFFIDAVIT

I, __________, __________, resident of __________, holding __________, in respect of property within __________ (the "Deponent" or "I"), do hereby solemnly affirm and declare as follows:

1. THE PROPERTY AND THE AUTHORITY

2. MY RIGHT TO OCCUPY

3. NO DUPLICATE CONNECTION

3.1 No other water or sewerage connection exists, or is being separately applied for, in respect of the same property, except the one referred to in this affidavit, and I have not obtained and am not seeking more than one connection for the same premises to defeat the authority's tariff or metering rules.

4. DUES

5. DECLARATION

VERIFICATION

DEPONENT

Signature: ______________________________
__________

ATTESTATION

Notary Public / Oath Commissioner
Registration No. and seal: ____________________

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