DO NOT SUBMIT THIS FORM UNTIL YOU HAVE RECEIVED WRITTEN ELIGIBILITY APPROVAL FROM LMUD.
Requested Connection Date
Date Format: MM slash DD slash YYYY
DISCLAIMER: By inserting an “Requested Connection Date,” the Property Owner agrees that the connection date is not guaranteed by LMUD, and that the Service Address connection date to LMUD’s Reuse Water system is subject to change at any time depending on such factors as the overall project schedule, cost, labor availability, and other factors affecting LMUD’s ability to perform this work, as LMUD may determine.
I understand that I may request any date in the future to start service, but service addresses requiring a tap and meter be set prior to service require at least a 2 week (10-business days) advance notice of requested connection date. Connection date is not guaranteed.
Charges will begin once meter has been set.
Customer #2 Information
- LMUD accepts payments made by credit card or debit card (one-time or automatically recurring), personal check, cashier’s check, money order, bank draft (one-time or automatically recurring), or on-line. A return item feewill be assessed if payment is rejected. A late fee may also be assessed.
If yes, provide a valid email address under the Customer Information section, above
Complete the Authorization for Automatic Payments form and return it to LMUD.
Lakeway Municipal Utility District
1097 Lohmans Crossing
Lakeway TX 78734-445
Fax: (512) 261-6681
Please do not submit this form via email.
- All Customers:
Customer must pay a nonrefundable Service Fee, which is due at the time of submittal of an Application and Service Contract. In addition, once service commences, Customer must pay all rates, fees, and charges and comply with all rules and regulations of LMUD now existing or as may be revised in the future.
- Water Customers:
Customer shall install, at Customer’s own expense, a tap (if no tap is preexisting), a water service line commencing at LMUD’s water meter and connecting to the Customer’s home or place of use, and a cut-off valve. Customer shall be fully responsible for the service line from the water meter to Customer’s home or place of use, including the installation of an approved back-flow device if required. Tampering with LMUD’s water meter or using LMUD’s water cutoff valve is prohibited.
- Wastewater Customers:
Customer shall install, at Customer’s expense, a tap (if no tap is preexisting) and aback-up relief valve, and must request inspection of same by LMUD after installation. More information is available on LMUD’s website at: https://lakewaymud.org/service-providers/guideline-requirement-documentation/wastewater-back-up-relief-valve-installation-guide.
- Customers with a grinder pump at their property are required to fill out a Grinder Pump System Service and Maintenance Addendum.
- Important Note: If a grinder pump is present or required, LMUD will provide maintenance per the FY 2019/2020 Rate Order update.
- For LMUD-installed grinder pumps, additional installation fees may apply.
- For customer-installed grinder pumps, some repairs may require additional fees.
- For all customers with a grinder pump, please call us to request a work order for maintenance to be performed
General Terms of Service
After approval of this Service Contract by LMUD, LMUD will sell and deliver water and/or wastewater to the Customer, and the Customer shall receive and pay for such service(s) in accordance with LMUD’s most current Rate Order, other orders, rules and regulations, policies, guidelines, Water Conservation Plan, and Drought Contingency Plan, as the same may be amended from time to time by LMUD in its sole discretion. As evidenced by its signature below, Customer expressly agrees to comply with and be bound by Lustrate Order, other orders, rules and regulations, policies, guidelines, Water Conservation Plan, and Drought Contingency Plan, as the same may be amended from time to time by LMUD in its sole discretion, and agrees to the imposition and payment of fines and penalties for noncompliance.
LMUD has the authority to discontinue service to any Customer not complying with Lustrate Order, policies, rules, or regulations, or for non-payment of utility fees and other Mischarges. If service is discontinued, service will not be re-established until Customer has corrected all conditions that caused the termination. In some cases, a new Application for Service and Contract for Service must be submitted.
Rates, Fees, and Charges
- LMUD’s rates, fees and charges shall be those adopted by the LMUD Board of Directors in its Rate Order, which may be revised from time to time by LMUD’s Board of Directors in its sole discretion. A brief summary LMUD’s current rates, fees and charges fees are available at LMUD’s Administrative Offices and on-line.
- By the signature(s) below, the Customer(s) hereby grant(s)to LMUD any easements or rights-of-way required for the purpose of installing, inspecting, maintaining, and operating pipelines, meters, valves and any other equipment that may be required to extend or improve service by LMUD to Customer.
Notice of Right of Confidentiality
- Section 182.052 of the Texas Utilities Code requires LMUD to notify customers of their right to confidentiality. You are hereby informed that you have the right to request confidentiality of your address, telephone number, social security number and any information relating to the volume or units of utility usage and the amounts billed to or collected from you for utility usage, as contained in LMUD’s records. To exercise your rights, please complete the Notification of Right of Confidentiality of Customer Information and return it to LMUD.
Customer Certification and Signatures
By my/our signature(s) below, I/we hereby certify the information provided herein and following statements are true and correct:
of the property located at the Service Address listed above [referred to as the "Customer" herein]. Customer desires to contract with Lakeway Municipal Utility District (LMUD) to receive water and/or wastewater service from LMUD to the property located at the Service Address listed above.
Customer hereby agrees to pay all rates, fees, and charges and to comply with all Rate Orders, other orders, rules, regulations, codes, and guidelines of LMUD now existing or as may be revised by LMUD in the future in LMUD’s sole discretion. Customer further agrees to comply with and be bound by LMUD’s Rate Order, other orders, rules and regulations, policies, guidelines, Water Conservation Plan, and Drought Contingency Plan, as the same may be amended from time to time by LMUD in its sole discretion, and agrees to the imposition and payment of fines and penalties for noncompliance
CUSTOMER AGREES TO WAIVE, RELEASE, AND HOLD LMUD HARMLESS FROM ANY CLAIMS AND DAMAGES RESULTING FROM MALFUNCTION, FAILURE, OR ABSENCE OF CHECK VALVES, BACKFLOW PREVENTION DEVICES, AND PRESSURE RELIEF VALVES, INCLUDING WITHOUT LIMITATION, DAMAGES TO PERSONSOR PROPERTY, DIRECT DAMAGES, SPECIAL DAMAGES, INCIDENTAL DAMAGES, CONSEQUENTIAL DAMAGES, OR LOSS OF PROFIT OR REVENUE.
This Agreement shall become effective when signed by a duly authorized representative of LMUD
Date Format: MM slash DD slash YYYY
Date Format: MM slash DD slash YYYY
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