Existing Commercial Service Application

Existing Commercial Service Application

Hernando County Utilities
Type of Service*
Requested Turn On Date*

MonthDayYear
Date
Ownership Type*

OwnerTenantOther
The Following is Required:

Photo ID, Fee Calculation Letter (if available),
Property Appraiser Address Receipt Letter (for each meter)

Owners - Signed copy of HUD or settlement statement, if applicable and Deposit.
Tenants - Lease Agreement or notarized Letter of Authorization and Deposit.
Agents - Property Management Agreement and Deposit

Application and payment are required to be submitted together at the same time. Applications will not be accepted by HCUD prior to two (2) weeks before requested service start date.

***DEPOSITS ARE BASED ON METER SIZE***
***If a field below does not apply simply type "NA".***
Service Location*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parcel Key Number*
You can find this value on the Property Appraiser's Property Search website.
Lot*
Block*
Unit*
Account Name*
Federal Tax ID*
Business Contact*

First NameLast Name
Business Mailing*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Attach Driver's License*

Cancelof
Attach Supporting Documentation (Property Lease or Ownership, Deed, Settlement Statement, Closing Disclosure, Property Management Agreement)

Upload up to 4 files
Cancelof
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Contract and Waiver
I acknowledge that I have been advised to be present at the above mentioned property at the time of water being turned on.
I understand that if I choose not to be present or have my authorized agent present at the time of the water being turned on, I hereby (initial) accept all responsibility for any damages and charges resulting from leaking, vandalism or negligence and further hold Hernando County harmless and without liability whatsoever.
I further understand that if the water meter indicates flow and/or a possible leak, the meter and service will not be left on and an (initial) additional trip charge will be billed to my account.
The undersigned applicant(s) for water/sewer service agree(s), jointly and severally, if applicable, to conform to and abide by all the rates, rules and regulations provided by ordinance, code, resolution or otherwise of the Hernando County Water and Sewer District for water and/ or wastewater service as are now or hereafter in force and which are a part of this contract. Applicant(s) further agree(s), jointly and severally if applicable, to pay water and wastewater hookup and connection fees where applicable and to pay all charges for water and/or wastewater service, as they may become due and at the scheduled rate in effect, unless and until notice in writing is given by the applicant(s) to the District through the Utilities Department that service is to be discontinued for whatever period of time. Connection fees paid to the Utilities Department are non-refundable by ordinance.
This application is subject to the Florida Public Records Law. Some persons may be entitled to have their personal information exempted from Public Records production. If you have any legal basis for exempting your information (law enforcement officers, certain government supervisory officials, etc.), please state the basis below. In the event of a Public Records request for your application, legal counsel will be asked to confirm whether the claimed exemption applies.*
Please state basis if answered YES to exemption. If answered NO type "NA":*
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Existing Commercial Service Application

Contract and Waiver