Wellston, OH · Jackson County
Release of Liability and Assumption of Risk to Reconnect Water Service
Property owners file this agreement with Wellston’s Water Department Clerk to request water service reconnection when no city representative or responsible party is present.
What this form is
This agreement lets a property owner request water service reconnection without a responsible party or city representative present at the property. Wellston requires the completed and signed form to be filed with the Water Department Clerk for this type of reconnection. It asks for the property owner’s name, property location, signature, date, and phone number, and describes the risks and release of liability.
Who needs it
A property owner requesting water service reconnection when neither a responsible party nor a city representative will be present at the property needs to file this agreement.
How to submit it
Forward the completed form to [email protected], or send it to the City of Wellston, 203 E. Broadway, Wellston, Ohio 45692, Water Clerk’s Office.
About notarization
This document is signed without a notary; the property owner signs and dates it, and no notarized attachment or sworn step is stated.
How to submit this form
- 1
Download the Form
Download the Release of Liability and Assumption of Risk to Reconnect Water Service form.
- 2
Complete the Form
Enter the property owner and property information, then provide the requested phone number.
- 3
Sign and Date
The property owner signs and dates the agreement.
- 4
Submit to Wellston
Forward the completed form to [email protected] or mail it to the Water Clerk’s Office at 203 E. Broadway, Wellston, Ohio 45692.
Frequently asked questions
- Do I need a notary for the Wellston water service reconnection release?
- No. The property owner signs and dates this agreement; it does not state that a notary, notarized attachment, or sworn step is required.
- How do I submit the Wellston water service reconnection release?
- Forward the completed form to [email protected], or send it to the City of Wellston, 203 E. Broadway, Wellston, Ohio 45692, Water Clerk’s Office.
- Who completes the water service reconnection agreement?
- The property owner completes and signs the agreement when requesting reconnection without a responsible party or city representative present at the property.
Need something notarized?
This Release of Liability and Assumption of Risk to Reconnect Water Service doesn’t need a notary — but if you have another Wellston form that does, a commissioned online notary can help.