*Name of account holder:
*Bill Date(s) I am inquiring about
*Is account on ACH? Yes No
Portion of bill I am concerned with:
Solid Waste Charges
Other (Please Specify)
*Please provide a brief summary of concern:
For concerns about water and / or wastewater charges,
please answer the following supplemental questions to help expedite your
Landscaping (please check all that apply)
Sod Date Installed
Trees and/or Plants Date Installed
Please provide other pertinent landscaping information:
Number of Zones
Water Minutes per Day
Watering Times per Week
Who manages the system? (Please check all that apply):
Property Manager Other
How often is it inspected? (Please check all that apply):
Date of Last Inpection
Please provide other pertinent irrigation system information:
Is there an auto-fill?
Date of last pool inspection:
Pool repairs? Yes
Date of pool repairs:
Date of last top/fill:
How often topped/filled?
Please provide other pertinent pool information
Outdoor Checklist (Please check all that apply):
Please provide any information regarding installation dates, leaks and/or
repairs and repair dates to the outdoor items listed above:
Have there been plumbing repairs to any of the following?
If so, please attach repair documents and/or receipts to this message. (Please check all that apply)
Please provide details regarding the following: (Please check all
and / or renovation work, on or adjacent to your property. Include new
construction, painting, concrete work and pressure washing.. Date
Cleaning; including pressure
washing, carpet cleaning and property preparation for a new tenant or owner.
Plumbing related repairs not
previously mentioned Date
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