Well Abandonment Agreement 

, in making an application for water service to said property (presently supplied by a well, which I maintain), hereby agrees to:

 
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IMPORTANT - this box must be checked
By checking this box and submitting this form, understand that AWC reserves the right to cancel the connection to the public water supply or discontinue water service if the conditions agreed to above are not complied with.

Note: All fields are required unless specified

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