Lehi City Corporation 153 N 100 E Lehi, UT 84043
(385) 201-1010 FAX (385) 201-1001
Full Name of Business ______________________________________________________ Phone _________________
Service Address ___________________________________________________________________________________
Applicant’s mailing address (if different from above) _____________________________________________________
Email___________________________________________ Requested Connection date ________________________
Federal Tax ID# __________________________________
Is Applicant Sole owner of the Business _____ Yes _____ No
If yes, Owner’s Name ___________________________________________________ Soc Sec # __________________
Drivers License # ______________________ Work Phone __________________ Cell Phone ___________________
Home Phone _________________________
If not, give the names of other owners (or if a corporation or partnership, other officers or general partners):
Own ____ Rent ____ Utility Contact Person __________________________________ Phone ___________________
Landlord information ________________________________________________________Phone _________________
PAYMENT The applicant agrees to pay monthly for the utility services rendered by Lehi City. Charges for service will be made at
the established rates for the class of service applicable to the applicant.
DELINQUENCY Payment for services is due immediately upon billing and shall be delinquent if not paid by the due date on the
bill. A penalty of 1.5% per month will be added to the delinquent account. The City may disconnect service on delinquent
accounts not paid 30 days following the due date. City shall not be liable for any damage resulting from such disconnection. In
order to restore service, the customer must bring current all delinquent charges. In addition, the City will charge a reconnection
fee. The applicant agrees to pay reasonable expenses of collection including attorney’s fees and court costs should it become
necessary to use such measures to collect the charges made to the applicant’s account.
REASONABLE ACCESS The applicant shall permit the City
s authorized representatives to enter on the customer's premises at
all reasonable times for purposes connected with rendering, billing, or disconnecting utility services.
TERMINATION OF SERVICE The applicant agrees to be responsible for the payment of utility charges incurred at these
premises until their responsibility is terminated in one of the following ways:
1. by verbal or written order by the applicant,
2. by the City's termination for lack of payment, as outlined previously,
3. upon completion of an application for services, at the premises, by another party.
Should customer change locations and occupy a subsequent or an additional location within the City, customer shall notify the
City promptly of such a change of address, and hereby authorizes City to note such change of point of delivery in the City's
Customer warrants that all information supplied in this contract is true and correct and understands that false and misleading
information shall be cause for the City to deny or cancel service and demand immediate payment of any amounts due.
The customer agrees to the above terms and conditions and agrees to be bound by the Rules and Regulations adapted from time
to time by Lehi City, and acknowledges that the undersigned has liability to the City for all obligations incurred at the location
during the term of the contract.
Applicant's Signature_________________________________________________________ Date ______________________________
Applicant’s Printed
Office use only
DEPOSIT AMOUNT $_______________ RECEIPT # _________________ CHECK # ___________________ DATE ___________________
ELECTRIC READING ____________________ DATE _____________ WATER READING __________________ DATE ________________
click to sign
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