Customers :: Form Types :: Lakeway Municipal Utility District

Please complete, print and mail or hand deliver the form below to

Lakeway Municipal Utility District
Administrative Office
1097 Lohmans Crossing
Lakeway TX 78734-445

Fax to (512) 261-6681

Please do not submit this form via email.

Section 182.052 of the Texas Utilities Code requires government-operated utilities 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 our records.

Please be aware that if you requested confidentiality in the past, you also have the right to cancel that request for confidentiality.

To exercise your rights, please complete the information requested on this form and return it to the address below. If you have requested confidentiality of your account information in the past, you do not need to resend.
Confidentiality Choice
- I hereby request confidentiality.
- I hereby cancel my request for confidentiality and give permission to disclose my information.
Name
First Last
Service Address
Street Address Address Line 2 City State Zip Code
Email
Phone
Signature
Date
MM slash DD slash YYYY
Email
This field is for validation purposes and should be left unchanged.

I,
Name*
First Last
am requesting automatic bank or credit card drafting to be terminated at the following service address:
Address*
Street Address
I am aware that if I wish to restart drafting again in the future I will be required to complete a new drafting form.
Signature
Date
MM slash DD slash YYYY
Email
Phone
This field is for validation purposes and should be left unchanged.

Name*
First Last
Email
Phone
Existing Service Address*
Street Address Address Line 2 City State Zip Code
Lakeway MUD Account Number
New Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
I understand that all future mailings will be sent to the new address. I will notify Lakeway Municipal Utility District if this is a temporary change and complete a new change of address request form.
Signature
Date
MM slash DD slash YYYY
Name
This field is for validation purposes and should be left unchanged.

STOP! Before filling out this form, please call our main office at (512) 261-6222 ext. 110 to confirm your location is serviced by Lakeway MUD.

If you prefer, you may instead print and mail or deliver this form. [ Printable Version ]
Application is hereby made for a variance to the Lakeway MUD Drought Contingency Plan as described below:
Customer Name*
First Last
Service Address*
Street Address City State Zip Code
Mailing Address
Same as Service Address?

Street Address Address Line 2 City State Zip Code
Phone
Email
Purpose of the water use:
Specific provision of the Plan from which applicant is requesting relief:
Detailed statement as to how the specific provision of the Plan adversely affects applicant :
Description of the relief requested:
Period of time for which the variance is sought:
Alternative water use restrictions or other measures the applicant is taking or proposes to take:
Other pertinent information:
The undersigned Applicant understands that the processing of this Application will be handled in accordance with the Procedure for Requesting Variances to the Drought Contingency Plan established by Lakeway MUD. It is further understood that acceptance of this application does not obligate LMUD to approve the variance
Signature
Date
MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.

Please fill out this form and we will get in touch with you shortly.

STOP! Before filling out this form, please call our main office at (512) 261-6222 ext. 110 to confirm your location is serviced by Lakeway MUD.
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
Problem being reported*
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Authorization for Automatic Payments