WATER USE EXCEPTION REQUEST

First Name (required):

Last Name (required):

Mailing Address (required):

Property Address (leave blank if same as above):

City, State, Zipcode (required):

Phone (required):

E-mail (required):

Utility Account #:

Reason for water usage:
New LawnNew LandscapingReseedResodPool DrainingOther

If Other, please be specific:

What dates are you requesting an exception for?
From: to

Please specify the time of day your project will be active:
From: 123456789101112AMPM to 123456789101112AMPM

Additional comments, if any:

I understand that it can take up to 72 hours for approval of the requested exception. I understand that my company and/or subcontractors must not utilize water outside of the provisions set out in the water use regulations, without an approval for exception. I further understand that if any damage is done to the city systems that myself and/or my company is responsible for, I will have to pay for damages. I understand that if the exception is not used within the allotted time, a new application must be made.

I, , agree to the terms above, and certify under penalty of perjury that to the best of my knowledge, all of the information submitted on this form is true.