Fillable SEWER CONNECTION PAYOFF REQUEST (Lake Havasu City)

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SEWER CONNECTION PAYOFF REQUEST (Lake Havasu City)

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Requests for payoff should be submitted via fax or email.
Payoff Requests will be responded to within 3 business days.
Please be sure to include the property address.
Lien Data should be obtained from the Mohave County Recorder's Office
Online Recorder's System
(in the event of questions)
or Your Fax No.
Property Address
Legal Description/Parcel
Your Name & Phone No.
Your Email Address
Deed of Trust or Security
Agreement # (Required)
Closing Date
Active Government Deed of Trust/Security Agreement?
YES NO
Balance Outstanding
Payoff Amount
Good Through
Comments:
All Checks Should Be Made Payable to: Lake Havasu City
Customer Name & A/R #
Statement Prepared By
FIN-37 Rev 07/2020
FAX TO: (928) 855-0551 OR EMAIL TO: sewerpayoffs@lhcaz.gov
CITY STAFF TO COMPLETE THIS SECTION
ADMINISTRATIVE SERVICES
LAKE HAVASU CITY
Payoff Request Form
Sewer Treatment Capacity Fee
2330 McCulloch Boulevard N., Lake Havasu City, AZ 86403-5950
Phone: (928) 855-2116 TDD: (928) 855-3945 Website: https://www.lhcaz.gov/
Date
City Representative Name
For Internal Use Only
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SEWER CONNECTION PAYOFF REQUEST (Lake Havasu City)

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Completed 23 January 2021

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