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Water Release Form

  1. The City of Balch Springs Logo

  2. RELEASE FORM

  3. Permission / Permiso

  4. I hearby give permission to the City of Balch Springs to turn my water meter on. I extend this permission in the event I am not present to inspect for leaks inside my home. I understand that any damage that may occur because of water being turned on is my responsibility and I release the City from any responsibility resulting from the meter being turned on.

    Doy permiso a la Ciudad de Balch Springs para que encienda mi medidor de agua. Extiendo este permiso en caso de que no esté presente para inspeccionar las fugas dentro de mi casa. Entiendo que cualquier daño que pueda ocurrir debido a la activación del agua es responsabilidad mía y libero a la Ciudad de toda responsabilidad derivada del encendido del medidor.

  5. Electronic Signature Agreement / Acuerdo de firma electrónica*

    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.

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  7. This field is not part of the form submission.