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2. First Name*
3. Last Name*
5. Service Address *
7. City*
8. State*
9. Zip*
11. Account Number*
12. Telephone Number*
14. Email Address
16. SELECT ONE - WATERING ADJUSTMENT OR DEDUCT METER
18. Watering Adjustment

    1. Click here to Request Watering Adjustment

    Per 50.017 (F) (1) The Treasurer and/or his or her designee may make adjustments downward in readings of water usage for sewer billing when there is evidence of a water leak; extensive watering of grass, flowers, shrubs and/or trees; and filling and maintaining a swimming pool. The city's "history" of water usage may be used to substantiate adjustments. EXTENSIVE is defined as three or more units of CCF usage, 30 units of DCF usage or 22 units of CGL usage beyond what the "history" shows to be the norm. A CCF unit is 748 gallons, a DCF unit is 74.8 gallons and a CGL unit is 100 gallons. Further, three units of CCF usage, 30 units of DCF usage or 22 units of CGL usage beyond a customer's typical usage during only one billing cycle will qualify for an adjustment.
20. Deduct Meter

    1. Click here to Request Deduct Meter

    Per 50.017(A) Any such meter shall be of approved design, shall be registered with the City Treasurer prior to use, and shall be used only by the user to whom it is registered and at the service location to which it is assigned. (B) Thereafter, the user shall bring said meter to the City Treasurer's office in October of each year where it may be read and those readings utilized to determine any meter usage since the previous reading.
22. Meter 1 Serial Number
23. Meter 1 Current Reading
25. Meter 2 Serial Number
26. Meter 2 Current Reading
28. Meter Reading Guide
    
30. Supporting Images
    The City permits the use of electronic filing of the reading(s) by uploading images of the meter reading and serial number here.
32. Digital Signature

    1. By checking this box, I agree to the below conditions.

    I understand that completion of this form does not guarantee an adjustment will be given. I certify that all the information submitted is true and correct and applies to the account for which the credit is sought.
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34. 1. Receive an email copy of this form.
35. Email address

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36. Submit

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