Utility Service Agreement (Move Outs, New Residents, Address Changes)

Service Address *

Billing Name *

Billing Address *

Owner Name *

Owner Address *

Start Date for Water/Sewer Service *

Contact Number

Email

#1 Resident/Occupant Name

#1 Resident/Occupant Social Security Number (Income Tax Department)

#1 Resident/Occupant Place of employment (Income Tax Department)

#2 Resident/Occupant Name

#2 Resident/Occupant Social Security Number (Income Tax Department)

#2 Resident/Occupant Place of Employment (Income Tax Department)

Prior Address

Any Additional Information (Or if you chose "Other" for Property Use)

EFFECTIVE MARCH 1, 2025 THE CITY OF LOUISVILLE HAS A RESIDENTIAL TRASH HAULER CONTRACT WITH KIMBLE.

Residential properties are defined in the contract as 1, 2 (duplex), or 3 (triplex) family dwellings. Please contact Kimble Recycling and Disposal Services at 1-800-201-0005 Ext. 9404 to set up service. Exclusions to participating in the contract are businesses, construction sites, commercial contracts, multi-family/apartment complexes (with more than three units), or if an HOA and/or private street contracts with a waste company to provide service to all the residential households within their neighborhood.

I(WE) THE UNDERSIGNED APPLICANT(S) FOR WATER AND/OR SEWER UTILITY SERVICE, UNDERSTAND THE TERMS AND CONDITIONS OF SUCH SERVICES AS PRESCRIBED IN THE CODIFIED ORDINANCES, PART NINE: TITLE THREE, OF THE CITY OF LOUISVILLE AND AGREE TO ABIDE BY SAID PROVISIONS. I (WE) HEREBY SWEAR OR AFFIRM THAT I(WE) OWN THE REAL ESTATE TO BE SERVICED BY THE WATER AND/OR SEWER UTILITY SERVICES DESCRIBED IN THIS AGREEMENT.

LOUISVILLE CITY ORDINANCE 931.021 STATES THAT THE REAL ESTATE OWNER IS LIABLE FOR ALL SERVICE CHARGES AND APPLICABLE BILLS/INVOICES WILL BE SENT DIRECTLY TO THE REAL ESTATE OWNER. IF THE PROPERTY IS A RENTAL, IT IS THE REAL ESTATE OWNER’S RESPONSIBILITY TO PAY THE BILL OR PASS THE BILL ALONG TO THE TENANT(S) ACCORDINGLY.

Signature *