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2. Date*
   Date
3. Check All Applicable Services:*

   1. Water
   2. Sewer
   3. Trash
5. Check Applicable:*

   1. Owner
   2. Renter
   3. Property Manager
7. First Name on Account*
8. Last Name on Account*
10. Home Phone*
11. Cell Phone*
13. Work Phone*
14. Email Address*
16. Spouse / Roommate Information
18. First Name*
19. Last Name*
21. Home Phone
22. Cell Phone
24. Work Phone
25. Email Address
27. Previous Address*
29. City*
30. State*
31. Zip Code*
33. Country*
34. Date to End Service*
    Date to End Service
36. New Service Address*
38. City*
39. State*
40. Zip Code*
42. Country*
44. Alternate Billing Address
46. City
47. State
48. Zip Code
50. Country
52. Date to Begin Service*
    Date to Begin Service
53. New Residential Account only - Number of garbage cans (A 95-gallon recycle bin is included):
55. Would you like to receive your bill by e-mail?*

    1. Yes
    2. No
56. Voluntary $1.00 Monthly Donations:

    1. Police
    2. Fire
58. Non-Refundable Transfer Fee is $20. In addition, any past due balance on the previous account must be paid before new service is started.
60. Town of Prosper Services Agreement

    Water, Sewer & Solid Waste 

    1. Water. The Town of Prosper water meters are read electronically twice daily and the readings are transmitted to Data Collection Units (DCUs) that are linked to the Town's utility billing system. Water readings are downloaded for residential and commercial billing at approximately the same time period each month for billing purposes. Water fee is comprised of a minimum service charge and a volumetric charge. 
    2. Sewer. Residential sewer charges are based on the average from water consumed in the months of December, January and February. This establishes a winter average which is used in calculating the monthly sewer charge for the entire year. Each March the sewer is recalculated from data collected from December, January and February. Customers who have not been billed for any of those months will not have a winter average and will cap out at 10,000 gallons for each monthly bill until a winter average has been established. Commercial sewer bill is comprised of minimum service charge and a volumetric charge. 

    
    

    1. Solid Waste. Solid waste is picked up weekly with one bulk pick up per month included. 
    2. Rates. Rates are subject to change annually after a rate study is completed by a third party and approved by the Town Council. Current rates are posted on the Town's website or are available at the Utility Billing Office. 
    3. Payments. Utility payments are due by the 10th of each month. The Utility Billing Office is located at 250 W First Street and is open Monday through Thursday 8 am until 5:30 pm and Friday 8 am until 5 pm. Payments are accepted by cash, check, money order, cashier's check, credit card, debit card and auto draft of checking, savings, and credit card. No payments are accepted by phone. Please allow 10 days for mail delivery. Payments sent by mail must be addressed to:
       P.O. Box 307
       Prosper, TX 75078
       Payments may be made after hours by using the night box located in the northwest corner of Town Hall in the parking lot. Payments made overnight or on the weekend will not be posted until the next business day. 
    4. Penalty. Should the amount due on the 10th day of the month following the billing cycle not be paid in full, a 10% penalty will be incurred. 
    5. Return payments. Payments returned for any reason from a financial institution or pay system will incur a $25 return fee for each item. 
    6. Disconnect. If payment is not received ten days from after the due date a disconnect notice will be generated and mailed to the account holder's billing address. The Town is not required to send additional notices in order to be authorized to discontinue service. Current fees associated with this action are posted on the Town's website or are available at the Utility Billing Office. Accounts that have been disconnected may be referred to a collection agency. Disconnection does not mean "termination". 
    7. Termination of Services. It is the responsibility of the account holder to request their account be final. All charges that are incurred up to the account final date are the financial responsibility of the account holder. Unpaid balances may be referred to a collections agency. Balances on inactive accounts may be transferred to an active account of the same name when one is present. After 90 days of non-payment of full balance account may be final and account holder will then have to re-apply for services if needed.

    Cross Connections

    1. Purpose. The Town of Prosper is responsible for protecting the drinking water supply from contamination or pollution, which could result from improper private water distribution system construction or configuration. The purpose of this service agreement is to notify each customer of the plumbing restrictions, which are in place to provide this protection. The utility enforces these restrictions to ensure the public health and welfare. Each customer must sign this agreement before the Town of Prosper will begin service. In addition, when service to an existing connection has been suspended or terminated, the water system will not re-establish service unless it has a signed copy of this agreement. 
    2. Restrictions. The following unacceptable practices are prohibited by State regulations. 
       1. No direct connection between the public drinking water supply and a potential source of contamination is permitted. Potential sources if contamination shall be isolated from the public water system by an air gap or an appropriate backflow prevention device. When private wells are installed for personal use, the owner shall install a RPZ backflow device near the meter to insure no cross connection could compromise the Public Water System. 
       2. No cross-connection between the public drinking water supply and a private water system is permitted. These potential threats to the public drinking water supply shall be eliminated at the service connection by the installation of an air gap or a reduced pressure-zone backflow prevention device. 
       3. No connection which allows water to be returned to the public drinking water supply is permitted. 
       4. No pipe or pipe fitting which contains more than 8.0% lead may be used for the installation or repair of plumbing at any connection, which provides water for human use. 
       5. No solder flux, which contains more than 0.2% lead, can be used for the installation or repair of plumbing at any connection, which provides water for human use.
62. Service Agreement

    The following are the terms of the Service Agreement between the Town of Prosper and the following customer:

64. Customer First Name*
65. Customer Last Name*
67. Service Address*
69. City*
70. State*
71. Zip Code*
73. Country*
75. 1. The Utility Billing Department will maintain a copy of this agreement as long as the customer resides at the premises. 
    2. The customer shall allow his property to be inspected for possible cross-connections and other potential contamination hazards. These inspections shall be conducted by the Public Works Department or its designated agent prior to initiating new water service; when there is reason to believe that cross-connections or other potential contamination hazards exist; or after any major changes to the water distribution. The inspections shall be conducted during the Public Work's normal business hours. 
    3. The Public Works Department shall notify the customer in writing of any cross-connection or other potential contamination hazard, which has been identified during the initial inspection or the periodic inspection. 
    4. The customer shall immediately remove or adequately isolate any potential cross-connections or other potential contamination hazards on his premises. 
    5. The customer shall, at his expense, properly install, test, and maintain any backflow prevention device required by the Public Works Department. Copies of all testing and maintenance records shall be provided to the Public Works Department. 
    6. All water meters and associated reading equipment are the property of the Town of Prosper. In the event equipment becomes damaged and it is determined it was done in a malicious manner the cost of the equipment, labor and installation will be charged to the account holder. Meters and associated reading equipment shall not be tampered with, disconnected, or connected by anyone except an authorized representative of the Town. Violations for meter tampering destruction of Town property, connecting or disconnection of service will be dealt with according to the State Laws of Texas and the ordinances of the Town of Prosper. 
    7. The customer has read and agrees to accept this agreement. Enforcement. If the customer fails to comply with the terms of the Service Agreement, the Town of Prosper shall terminate service. Any expenses associated with the enforcement of this agreement shall be billed to the customer.
77. Customer E-Signature (First and Last Name)*
78. Date*
    Date
80. All information submitted to municipal government entities is subject to the Texas Public Information Act. This Act states that your utility information is subject to open records requests by third party entities, unless otherwise noted. Please indicate if you would like your utility billing information to be available for such requests.*

    1. Yes, my utility information may be released for public information requests.
    2. No, my utility information is to be withheld from public information requests.
82. Customer E-Signature (First and Last Name)*
83. Date*
    Date
Leave This Blank:


85. 1. Receive an email copy of this form.
86. Email address

    This field is not part of the form submission.

87. Submit

* indicates a required field