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2. Service Start Date*
   Service Start Date
4. Applicant Name*
6. Additional Applicant Name
8. Service Location*
10. Mailing Address If Different From Service Location
12. Home Phone Number*
13. Alternate Phone Number
15. Email*
17. Are you a new owner or renter?*

    1. A New Owner
    2. Renter
19. Property Management/Landlord or Escrow Company Name and Phone Number*
21. Select your cart size for solid waste service*

    1. 20 gallon
    2. 35 gallon
    3. 65 gallon
    4. 95 gallon
    5. Yard Waste (Optional)
23. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
25. Electronic Signature*

    I understand the yard waste contract and terms will be provided with my welcome packet and l will abide by the terms and conditions therein.

27. For security purposes and privacy of your account information, the following information is required: Applicant Social Security Number - last 4 digits only*
29. Applicant Driver's License Number - last 4 digits only / State*
31. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
33. Electronic Signature*
34. Date*
    Date
36. 1. If water is currently off at the property, ensure all faucets/spigots are in the "off position" to avoid flooding. The City of Oak Harbor is not liable for any flooding due to leaks or faucets/spigots being left in the "on position".
    2. Requests to reactivate water service must be received in our Utility office during normal business hours of 8 am - 4:30 pm, Monday through Friday, excluding holidays. Requests to reactivate water service after business hours may incur a $75 fee.
    3. Utility bills are dated the 20th of each month, due the following month no later than the 18th by 4:30 pm. Payments received after the due date are subject to a penalty of $15, plus.67% for each outstanding commodity.
    4. If you do not receive your monthly bill by the end of the month in the mail, contact our office for the bill amount.
    5. A copy of the tenant's bill is also mailed to the owner/property management.
    6. All roll cart lids must be completely closed, curbside by 7 am, and unobstructed 3-5 feet in order to be serviced on your pick up day.
    7. A blue 65g recycling cart is provided at no charge. See recycling brochure for service terms. Contaminated cart may be charged a contamination fee.
    8. Only place designated items in the trash, recycle, and yard waste carts. If unacceptable items are placed in the trash, recycling, or yard waste carts service will be denied and a return fee may be charged.
    9. Roll carts, except for yard waste remain with the property upon move-out. Upon move-out, schedule to have your yard waste cart picked up and removed.
    10. Yard waste service during December, January, and February are reduced to the first service day of the month with a reduced monthly fee of $3.25.
    11. Any requests to have water turned off/on at the meter requires a City water specialist, please contact our office. Do not attempt to access the City's water meter. A $15 fee to turn the water back on will be charged.
    12. A delinquent account is subject to disconnection of services with a $40 fee assessed at disconnection.
    13. Returned payment items will be assessed a $40 fee. Two returned items within a 12-month period will result in cash only payments.
38. I have read and understand the above information.*

    1. Yes
40. Acknowledgement*

    1. I Agree

    The account will activate after payment of the $25 admin fee. Call the utility office at 360-279-4530 to make the payment over the phone. The welcome packet with utility account number, costs, and service terms will be emailed to you once the account is activated.

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42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field