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Request for Sewer Credit
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REQUEST FOR SEWER CREDIT
NAME ON ACCOUNT
BEST CONTACT PHONE
Requirements to qualify for a sewer credit:
1. Sewer Credits are limited to once in a twelve (12) month period.
2. The consumption must exceed your 6 month average.
3. Attach a copy of the repair bill, pool contract or provide a statement explaining when and how the repair was made with copies of receipts for repair supplies.
NO REQUEST WILL BE PROCESSED WITHOUT VERIFICATION OF THE REPAIR
Sewer credits will NOT be granted for the following reasons:
1. Broken or leaky water lines where the water enters the sanitary sewer system. (i.e. leaky toilets or inside faucets)
2. Water used for irrigation.
3. Negligent use of water.
4. Underdetermined use of water.
REASON FOR REQUEST FOR SEWER CREDIT
1. POOL FILL
REPAIR (attach copy of repair bill)
Date/Range of Consumption
# of Gallons Required
*Must attach a copy of pool specifications and/or pool dimensions for above ground*
2. LEAK (other than pool leak)
Date/Range for Consumption
Brief description of water leak including location of problem:
I UNDERSTAND THAT THIS FORM MUST BE FILLED OUT COMPLETELY FOR MY ACCOUNT TO BE CONSIDERED FOR A SEWER CREDIT
SIGNATURE OF ACCOUNT HOLDER
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Stormwater Utility Fee
West Melbourne Media
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