Testing Testing 123 - Garland City Utah

Applicant/Owner Name(Required)

First Last

Co-Applicant(Required)

First Last

Service Address(Required)

Street Address Mailing Address (if different from service address) City State / Province / Region ZIP / Postal Code

Primary Phone(Required)

Secondary Phone

Drivers License Number Owner(Required)

Email(Required)

Receive Statement by Email(Required)

Yes

No

Owner's Date of Birth(Required)

Co-Owner's Date of Birth(Required)

Place of Work(Required)

Work Phone(Required)

Date of Application

Date of Responsibility

Are you moving from another Garland Address:(Required)

Yes

No

Is this a rental property?(Required)

Yes

No

Application Agreement

This application includes the following fees: Water, Sewer, and Garbage Services from Garland City for the premises shown above and agrees to the following:

(1) To Pay Garland City for all services billed until such time as the applicant shall direct these city services to be discontinued.
(2) Upon disconnection request: Water, Sewer, and Garbage Services will be discontinued.
(3) In the event of a failure to pay for these services, the city shall have the right to take action to establish by law to include but not limited to:
- a. Assessment of reconnection charges, penalties, and fees.
- b. Discontinue services until all delinquent fees imposed are paid in full; whether by credit card, cash, or money order at the city offices.
- c. Seek the services of a collection agency for all delinquent charges and any fees imposed. d. File a Property Tax Lien with the Box Elder County Treasurer's Office for all delinquent charges and any fees imposed. All laws applicable to the levy, collection, and enforcement of the city real estate property taxes shall be applicable to such an assessment.
(4) In the event applicant fails to conform to the ordinances and regulations established by law, the city shall have the right to discontinue Services at its election until there is full compliance with the law.
(5) To pay any and all attorney fees, reasonable collection and court costs, and interest for unpaid utility services.

Acknowledgement

I understand and agree to these terms.

I understand and agree to these terms.(Required)

Yes

Applicant/Owner Signature(Required)

First Last

Co-Applicant Signature(Required)

First Last

Comments

This field is for validation purposes and should be left unchanged.

Garland City Utility Application

Application Agreement

Acknowledgement

Garland City Phone

Address

Email

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