The undersigned hereby requests Water Works District No. 3 of Rapides Parish to render water service at the above service address, grants to the District the necessary right-of-way for the extension of such service which is binding upon the undersigned's heirs or assign, and agrees to receive from and pay the District all such services required on the premises at above service address, in accordance with applicable rates and with the service regulations of the Water District.

The Water Works District No. 3 of Rapides Parish has "Intergovernmental and Cooperative Endeavor Agreements" in effect with the City of Pineville, Town of Ball, and Rapides Parish Sewerage District No. 2, that allow termination of your water service for failure to pay your public utility/services bill from those agencies. Those public utility/services bills must be paid directly to those agencies and Water Works District No. 3 of Rapides Parish cannot accept any payment for those utility/services bills.