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CHAPPELL HILL WATER SUPPLY CORPORATION Water Tariff

SECTION 2.0 - PRELIMINARY APPLICATION FOR WATER SERVICE

The following preliminary information must be furnished to the Water Corporation before further consideration of a final application can be made.

Date_______________

Applicant's Name____________________________________________

Location of Property for Water Connection _____________________________________

Phone Number _____________________

Name of Legal Property Owner:__________________________________________

Property Owner Mailing Address _________________________________

_________________________________

Driver's License Number:________________________________________

Current or previous customer of the Corporation? _______________

Is this a Membership Transfer? ____________________

Category (check one)

1. Residential

2. Commercial

3. Industrial

4. Institutional

5. Residential subdivision

6. Developer

Based on the information submitted above, the Corporation will make a determination whether to proceed with the application.

Effective 10/23/2008