Utility Department



I hereby request to be supplied water, sewer and solid waste service by the City of Venice to the premises on the property described below, for which I agree to pay the Customer Service/Finance Department in accordance with the schedule of rates of the City, and further to comply with the rules and regulations of the City and provisions of the Municipal Code of Ordinances, as amended, and to make them a part of this agreement.

I agree to make no, and hereby waive, any claim that I may have against the City or its agents on account of the stoppage of flow of water if caused by accident or if necessary to make alterations, repairs or improvements, and I agree to keep all plumbing and fixtures on my premises in repair and to promptly stop any leaks. I further agree to post the required deposit with the City, and I realize and agree that this deposit shall not preclude the City from discontinuing for nonpayment any and all services covered by this deposit regardless of the sufficiency of the deposit to cover any indebtedness for such services.

I understand there may be unpaid water, sewer and solid waste charges for the premises described below. The City cannot determine what these charges are until the meter is read. I understand that unpaid water, sewer and solid waste charges, even if incurred by the prior owner, become a lien against the property where furnished and that the City may cut off the water and solid waste collection to the premises upon my failure to pay any of said charges.

Service Start Date:
Service Address:
Applicant Name:
State / Drivers License Number:
Co-Applicant Name:
Phone Number:
Alternate Phone Number:
Billing Street Address:
I am the Owner Tenant
I agree to post the required deposit with the City Yes No
Additional Comments: