Water Variance Application

Name of Property Owner *

First Last

Address *

Street Address Address Line 2 City State ZIP Code

Subdivision

Contact (Responsible Party) *

First Last

Phone *

Email

Sprinkler System? *

Yes
No

Building Permit Number if system is new

Please call 350-9830 to get a permit.

Type of new lawn *

Square feet of lawn *

Cubic yards of compost *

Date installed *

Location of lawn *

An original receipt or invoice for seed or sod *

Max. file size: 400 MB.

An original receipt/invoice for compost (not topsoil, amended topsoil or fertilizer) *

Max. file size: 400 MB.

A photo of rototilling or receipt of tiller purchase/rental *

Max. file size: 400 MB.

Signature *

I hereby certify that all information provide here is correct and truthful and give permission to the Water Department Staff to inspect the property. I also understand that if I fail to abide by the rules, I may have my variance revoked.

E-Signature *

Please type your name, indicating that you have read and agree to the above statement.

Date *

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