VILLAGE OF MILFORD
WATER TURN ON WAIVER
Date ____________________________
I have declined to be present at the listed location during the turn-on process. The Village of Milford Water Department has fully explained and I understand the potential risks and damage that may result if I am not present when the Milford Water Department turns on my water service. I understand that water could leak from any open faucet, toilet or water pipe located inside or outside the property.
BY SIGNING THIS WAIVER I ACCEPT ALL RESPONSIBILITY FOR POTENTIAL DAMAGES AND AGREE TO HOLD THE VILLAGE OF MILFORD HAMRLESS FOR ANY DAMAGE THAT RESULTS FROM TURNING ON WATER SERVICE WHILE I AM NOT PRESENT.
By signing this form, I represent that I am the owner of this property or that I have the authority on behalf of the owner to request this service by the Village of Milford.
Service address: ______________________________________________________
Printed name: ________________________________________________________
Signature: ___________________________________________________________
Witness: ____________________________________________________________
Business Name (if applicable) ___________________________________________
Title (if applicable)____________________________________________________ | 
