Cy-Forest WSC – Application for Utility Service

Application for Utility Service

Cy-Forest WSC

Application processing time is 2 business days. For next business day service, please visit one of our two locations: (Houston) 17707 Old Louetta Rd., Houston, TX 77070, or call 281-376-8802 OR (Spring) 19720 Kuykendahl Rd., Spring, TX 77379, or call 281-651-0861.

Are you a company applying for Residential Utility Service?

Are you applying for Commercial or Residential Utility Service? *

Commercial
Residential

Address for Service Request - Street Address *

Address for Service Request - City, State Zip Code *

First Name of Applicant *

Last Name of Applicant *

Name of Joint Applicant

Telephone Number

Date to Begin Service *

Billing Address - Street Address (Indicate If Same As Above)

Billing Address - City, State Zip Code (Indicate If Same As Above)

Rent, Own, or Manage Home?

Please provide lease agreement, closing disclosure, or management agreement. (.jpg or .pdf format) *

Click or drag a file to this area to upload.

Your Email *

Previous Address

Previous Address - City, State Zip Code

Please provide photo of ID/license. (.jpg or .pdf format) *

Click or drag a file to this area to upload.

Authorized Caller First & Last Name:

Additional Comments

The District requires a security deposit and application fee to setup service. Payment options will be emailed to you.

Statement of Responsibility

It is the customer's responsibility to ensure that the home is prepared for water service. Any leak after the meter, or inside the home, or damages arising from a leak or fixtures left open inside the home, will be the customer's responsibility.

I have read and accept the Statement of Responsibility: *

Applicant’s failure to adhere to all requirements contained in the District’s Rate Order may result in fines, penalties, and a delay or denial of service. A copy of the District’s Rate Order is available upon request.

E-Signature Authorization

First Name *

Last Name *

Drivers License Number *

Today's Date

I have read and accept the E-Signature Authorization:

Service Agreement

AGREEMENT made this ____ day of ________________, 20____. between Cy-Forest Water Supply Corporation, a non-profit water supply corporation organized under the laws of the State of Texas (hereinafter called the Corporation or Cy-Forest) and (hereinafter called the Member).

Witnesseth:

The Corporation shall sell and deliver water service to the Member and the Member shall purchase. receive, and/or reserve water service from the Corporation in accordance with the Bylaws and Tariff of the Corporation as amended from time to time by the Board of Directors of the Corporation. Upon compliance with said policies, including payment of any membership fee adopted by the Board, the Member qualifies for Membership as a new Member or continued Membership as a Transferee and thereby may hereinafter be called a Member.

The Member shall pay the Corporation for service hereunder as determined by the Corporation's Tariff and upon the terms and conditions set forth therein, a copy of which is available for review at the Cy-Forest office, upon the request of any Member.

All water shall be metered by meters to be furnished and installed by the Corporation. The meter and/or connection is for the sole use of the Member or customer and is to serve water to only one (1) dwelling and/or only one (1) business. Extension of pipe or pipes to transfer water from one property to another to share, resell or sub-meter water to any other persons, dwellings, business. and/or property, etc. is prohibited.

The Corporation shall have the right to locate a water service meter and the pipe necessary to connect the meter on the Member's property at a point to be chosen by the Corporation. and shall have access to its property and equipment located upon Member's premises at all reasonable times for any purpose connected with or in the furtherance of its business operations. and upon discontinuance of service the Corporation shall have the right to remove any of its equipment from the Member's property.

The Corporation's authorized employees and agents shall have access to the Member's property or premises and service lines and plumbing facilities at all reasonable times for the purpose of inspecting for possible violations of the Corporation's policies and to ensure compliance with the state required Minimum Acceptable Operating Practices for Public Drinking Water Systems, as promulgated by the Texas Commission on Environmental Quality or successor agency, applicable plumbing codes, and utility construction standards. The Corporation strictly prohibits any direct connection between the public drinking water supply and a potential source of contamination. Potential sources of contamination shall be isolated from the public water system by an air- gap or an appropriate backflow prevention device. The Corporation strictly prohibits any cross connection between the public drinking water supply and a private water system. These potential threats to the public drinking water shall be eliminated at the service connection by the installation of an air-gap or a reduced pressure-zone backflow prevention device. The Corporation strictly prohibits any connection which allows water to be returned to the public drinking water supply.

The Member shall allow his property to be inspected for possible cross-connections and other unacceptable plumbing practices. These inspections shall be conducted by the Corporation or its designated agent: (i) prior to initiating new water service; (ii) when there is reason to believe that cross-connections or other unacceptable plumbing practices exist; and/or (iii) after any major changes to the private plumbing facilities. The Corporation shall notify the Member in writing of any cross-connection or other unacceptable plumbing practice which has been identified during the initial inspection or the periodic re-inspection. The Member shall immediately correct any unacceptable plumbing practice on his premises. The Member shall, at his expense. properly install, test. and maintain any backflow prevention device required by the Corporation. Copies of all testing and maintenance records shall be provided to the Corporation.

In the event the total water supply is insufficient to meet all of the needs of the Members, or in the event there is a shortage of water, the Corporation may initiate a water rationing plan. By execution of this Service Agreement, hereof, the Member shall comply with the terms of any water rationing plan imposed by the Corporation.

The Member shall install at his own expense a service line from the water meter to the point of use, including any customer service isolation valves and other equipment as may be specified by the Corporation. The use of pipes and pipe fittings that contain more than 8.0% lead or solders and flux that contain more than 0.2% lead is prohibited for any plumbing installation or repair of any residential or non residential facility providing water for human consumption and connected to the Corporation.

By execution hereof, the Member shall hold the Corporation harmless from any and all claims for damages caused by service interruptions due to waterline breaks by utility or like contractors, tampering by other Member/Users of the Corporation, normal failures of the system, or other events beyond the Corporation's control.

The Member shall grant to the Corporation, now or in the future, any easements and rights-of-way for the purpose of installing, maintaining, and operating such pipelines, meters, valves, and any other such equipment which may be deemed necessary by the Corporation to extend or improve service for existing or future members, on such forms as required by the Corporation.

By execution of this Service Agreement, Member shall guarantee payment of all other rates, fees. and charges due on any account for which said Member owns a Membership Certificate. MEMBER ACKNOWLEDGES THAT NONPAYMENT OF AMOUNTS DUE TO CY-FOREST WILL RESULT IN DISCONNECTION OF THE WATER SERVICE TO MEMBER'S PROPERTY. IN THE EVENT WATER SERVICE IS DISCONNECTED, A FEE SET BY CY-FOREST WILL BE CHARGED AND MUST BE PAID BEFORE SERVICE WILL BE RECONNECTED.

The Board of Directors shall have the authority to cancel the Membership of any Member not complying with any policy or not paying any utility fees or charges as required by the Corporation's published rates, fees, and conditions of Service. IF CY- FOREST'S EQUIPMENT IS TAMPERED WITH OR WATER IS TAKEN BY MEANS OF AN UNAUTHORIZED CONNECTION OR BOTH, THE MEMBER SHALL FORFEIT ALL RIGHTS AND PRIVILEGES OF MEMBERSHIP; THE MEMBER SHALL FORFEIT ALL CONNECTION AND TAP RIGHTS; THE METER SHALL BE REMOVED; AND THE LINE TAP SHALL BE SEALED.

By execution of this Service Agreement Member agrees that if Member fails to comply with the terms of this Agreement the Corporation shall, at its option, either terminate service or properly install, test, and maintain an appropriate backflow protection device at the service connection. Any expenses associated with the enforcement of the Agreement, shall be billed to and paid by the Member.

Any misrepresentation of fact(s) by the Member on any part of this Agreement shall result in discontinuance of service pursuant to the terms and conditions of the Corporation's Tariff.

Each Member must sign this Agreement before the Corporation will begin service. If service to an existing connection has been suspended or terminated, the Corporation will not re-establish service unless it has a signed copy of this Agreement. The Corporation shall maintain a copy of this Agreement as long as the Member and/or the Member's premises are connected to the Corporation.