Water Transfer Form

Application for Transfer of Water Service

The undersigned applicant hereby applies for a Transfer of Water Service to the above described property. The applicant is the new owner of the described property or the authority agent of the owner. By signing this application, the property owner agrees, as a condition of the LOST LAKE PROPERTY OWNERS ASSOCITAION, hereinafter referred to as the Purveyor, providing and continuing service to the above described property, to comply with all provision of the attached current Ordinance, Resolution and/or By-Laws of the Purveyor, or latest revision thereof, and other such attached rules and regulations now existing or which may be established from time to time governing the Purveyor’s water system. The property owner specifically agrees:

a)To install and maintain at all times his/her system in compliance with the most current edition of the Island County Plumbing Code as it pertains to the prevention of potable water system contamination, prevention of pressure surges and thermal expansion in his/her water piping (for thermal expansion, it shall be assumed that a check valve is installed by the Purveyor on the water service pipe).

b)As the condition of the Purveyor waiving the requirement for premises isolation by the property of a reduced pressure backflow assembly on his/her service pipe, to authorize the Purveyor’s request, to install, test, maintain, and repair in accordance with the Purveyor’s cross connection control standards (copy received with this application all in-premises backflow prevention assemblies require by the Purveyor to provide equivalent protection for the Purveyor’s distribution system; and to report to the Purveyor within 30 days of obtaining the results of all tests and repairs to aforementioned backflow prevention assemblies, and of making any change to the plumbing system.

c)Not to make a claim against the Purveyor or its agents or employees for damages and/or loss of production, sales or service, in case of water pressure variations, or the disruption of the water supply for water system repair, routine maintenance, power outages, and other conditions normally expected in the operation of a water system.

d)To pay his/her water billing with thirty (30) days from the date of billing.

After thirty (30) days of the Purveyor mailing a written notice to the property owner of his/her breach of this agreement, the Purveyor may terminate water service. In the event legal action is required and commenced between the parties to this agreement to enforce the terms and conditions herein, the substantially prevailing party shall be entitled to reimbursement of all its costs and expenses including but not limited to reasonable attorney’s fees as determined by the Court.

You are signing this form by submitting it.