Name:
Service Address:
Company Name:
Lot:
Block:
Tract:
APN Parcel No:
Legal Description:
1.
Pool
Yes
No
2.
Fire Sprinklers
Yes
No
3.
Irrigation Sprinklers (Vacuum Breakers)
Yes
No
4.
Irrigation Bubblers
Yes
No
5.
Well on Property
Yes
No
6.
Hospital, Clinic, Medical Bldg., Mortuary, Sanitarium, Nursing or Convalescent Home
Yes
No
7.
Industrial or Commercial (Describe)
Yes
No
8.
Duplex, Triplex, Motel, Apartments
Yes
No
9.
Public Building
Yes
No

If items 1, 3 and 4 are checked and continuous demand is greater than 10 gpm or a peak demand of 24 gpm, a 1” meter is required.

If response to item 5 is “Yes”, the required backflow devices will be installed by the District.

If response to item 6, 7, 8 or 9 is “Yes”, the builder must submit plot plan showing elevation of floor above center line of street and contractor’s calculated fixture units, in order that the District may determine what service size is required and what backflow protection is required. If applicable, see results of Engineering Study below.

COMMERCIAL APPLICATIONS

A field inspection will be made to determine total fixture units and a fee revision if necessary. If a commercial building is to receive sewer service from the District, it is recommended that a separate irrigation meter be installed in addition to the domestic meter to avoid unnecessary sewer charges.


TERMS AND CONDITIONS

The Mission Springs Water District (MSWD) owns, operates, and maintains the portion of the water service line from the water main to the outlet of the downstream side of the meter (“Service Connection”). Check valves or backflow prevention devices and separate domestic water and fire sprinkler system are part of the Customer’s private property service line The Customer is responsible for the private property service line and appurtenances subject to MSWD’s Water Regulations and Service Ordinance.

Customer acknowledges that MSWD will provide a single Service Connection to Customer’s property identified in this application (“Property”). MSWD may discontinue water service to the Property by following the provisions of its rules and regulations (“Regulations”) for any reason set forth in the Regulations, including, but not limited to, failure to make payment when due. If MSWD discontinues water service to the property, there will be no water service for the residential sprinkler system. In addition to the foregoing, Customer assumes all risk of loss or damage to personal and real property due to backflow from the fire sprinkler system portion of the Customer Service Line into the domestic portion of the Customer Service Line for any reason whatsoever, including without limitation, any water quality exceedance.

Customer shall assume the defense of, indemnify and hold harmless MSWD from and against all actions, causes of action, damages, demands, liabilities, costs (including, but not limited to reasonable attorney’s fees), claims, losses and expenses of every type and description (collectively, “Costs”) to which it may be subjected or put, by reason of, or resulting from: (A) the design, construction, testing (including inspection to ensure that such system is operational), operation, maintenance, repair and replacement of the residential fire sprinkler system located on the Property; (B) the performance of or failure to perform of the residential fire sprinkler system located on the Property during Customer’s ownership of the Property; (C) backflow from the fire sprinkler system portion of the Customer Service Line into the domestic portion of the Customer Service Line for any reason whatsoever, including without limitation, any water quality exceedance during Customer’s ownership of the Property; and (D) any death, injury, property damage, accident or casualty caused or claimed to be caused by the discontinuance of water service to the Property for any reason set forth in MSWD’s Regulations, including, but not limited to, failure to make payment when due, including any Costs arising from or in connection with the loss of the use of the residential fire sprinkler system on the Property during Customer’s ownership of the Property. MSWD shall make all decisions with respect to its representation in any legal proceeding concerning this Section. Customer hereby waives all claims and demands against MSWD for any such Costs.

Customer acknowledges that MSWD shall have no obligation nor responsibility with respect to the design, construction, testing (including inspection to ensure that such system is operational), operation, maintenance, repair or replacement of the residential fire sprinkler system in Customer’s Property which shall be Customer’s responsibility and Customer shall bear all risk of loss or damage thereto and/or thereby, by whatever cause inflicted which shall be Customer’s responsibility.

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