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2. 

                       7985 FM 2931, Aubrey, TX 76227

4. Spiritas Ranch
6. Phase
7. Tract
9. Company Name
11. Builder Phone Number
13. Builder Email Address
15. Accounts Payable Phone Number
17. Accounts Payable Email Address
19. Service Address
21. City
22. State
23. Zip Code
25. Lot
26. Block
28. Billing Address
30. City
31. State
32. Zip Code
34. Type of Service*
    -- Select One --Builder (Water & Sewer)Builder (Water, Sewer, & Irrigation)Irrigation (Water Only)
36. Electronic Signature Agreement

    1. Rates & Information

       Due to Mustang Special Utility District upon receipt of this request; Meter Set Fee $600.00, Water Connection Fee $4,500.00, Wastewater Connection Fee $6,000.00, Water Deposit of $100.00, Wastewater Deposit $50.00, Service Fee $25.00. All water will be metered by meters to be furnished and installed by Mustang SUD. The meter and/or connection is for the sole use of the member or customer and is to serve water to only one dwelling or only one business, and does not permit the extension of pipe or pipes to transfer water from one property to another nor share, resell, or sub-meter to any other person, dwelling, business, property, etc. 

       Builder assumes financial responsibility for any damage, theft, or vandalism to any Mustang owned or installed component, to include, but not limited to, meters, RTR units, wires, boxes, and valves

        • All CSI’s and backflow reports must be submitted through SC Tracking Solutions: 

            o www.sctrackingsolutions.com 

            o Customer Service: 1-866-232-0174 

       If not submitted within 30 days of completion of home, there will be an interruption of service or future meter set requests will be held until proper documentation is received.

        Bills are mailed out the 15th of each month and are due by the 1st. By signing below, I acknowledge and accept the rate order for Mustang SUD. 

       I understand that I will be responsible for these charges. These charges must be paid in full prior to placing the meter set on schedule.

       An email will be sent with the account number once the permit is processed. Pay online by entering your MSUD account number in the account number field and 0.00 in the last payment amount field.

    
    

    
    

    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.
38. Electronic Signature*
40. Date*
    Date
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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

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