DO NOT SUBMIT THIS FORM UNTIL YOU HAVE RECEIVED WRITTEN ELIGIBILITY APPROVAL FROM LMUD.

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.

Complete the Authorization for Automatic Payments form and return it to LMUD.

Lakeway Municipal Utility District
Administrative Office
1097 Lohmans Crossing
Lakeway TX 78734-445
Fax: (512) 261-6681

Please do not submit this form via email.

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.

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.

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.

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.

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