2. 

4. CITY OF OVIEDO PREMISE VISIT FEE AGREEMENT

6. Customer Name
8. Account Number
10. Address
12. Phone Number

14. Due to high consumption on my account, I am requesting that the City of Oviedo send a Water Conservation Officer to check my meter for a leak. 

    I understand that if no leak is evident, there will be a minimum $25.00 Premise Visit fee on my next bill. (Resolution 3019-15, Exhibit A, Section II, Miscellaneous Fees, Premise Visit Charge) If there is a leak, the $25.00 Premise Visit fee will not be charged. 

    By my signature below, I acknowledge that I have read and agree to the above listed conditions. 

16. 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.
18. Electronic Signature
22. Customer Service Representatives Signature
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24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

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