Waivers

The undersigned hereby gives the Kennebec Water District permission to operate privately owned valves for the following address.
Site Address*
Address where valve will be operated.
The signer hereby assumes all responsibility for damages and relieves the Kennebec Water District of all liability.
Name*
Phone Number*
Date*
Month
Day
Year
Digital Signature*
CAPTCHA
Phone

The Kennebec Water District requires the customer, or a responsible adult appointed by the customer, to be present when water service is activated. This allows the customer, or appointee, to verify there are no internal plumbing issues after the service is activated. The undersigned grants the Kennebec Water District permission to activate water service without a responsible adult present. The undersigned assumes responsibility and relieves the Kennebec Water District of all liability.
Name*
Address*
Phone*
Date*
Month
Day
Year
CAPTCHA
Digital Signature*