I, we, the undersigned (“Consumer”) hereby request water/wastewater service from Integra Water, LLC or its subsidiaries (“Utility”) at the Service Address and for the use stated below and none other. Consumer agrees to promptly pay the application fees, service fees, deposits, late fees, after-hours fees, processing fees and all other charges and fees of Utility ("Charges") at Utility's standard rates as set by Utility, now or at any future time, and to comply with Utility's rules, regulations, and policies, as modified from time to time by Utility ("Rules"). Utility's obligation to provide water/wastewater service issubject to (i) Utility's acceptance of this Application and (ii) the provisions of any water or sewer license, franchise, easement, right-of-way, or other agreements that may exist between Utility and any governmental authority or other person. Utility shall have exclusive right to furnish such service(s) to the Service Address. Consumer will read and comply with the Water & Wastewater Policy Manual available at www.integrawater.com or upon request from Utility at the address shown above. The signed Application and applicable Charges must be submitted to Utility at the address set forth above.