Water / Sewer Billing Credit

Request for Administrative Review - Water/Sewer Billing Credit
Instructions: Fill out the form below, and click "Submit Request". (all fields marked with * are required)
			examples
*Applicant Name:			Jane Doe
*E-mail Address:			jane@home.com
*Daytime Phone:			248-555-1212
*Mailing Address:
Billing Address:			(if different from above)

*Length of time at this address:
*Number of occupants:
Watered Lawn/Garden during months of:
*OR
Filled Swimming Pool on date:
If known, please give the number of gallons used, size of pool, or beginning and ending meter readings:

Additional Information:

IMPORTANT: You are responsible for paying current bill by the due date, as it may not be possible to process your request before the due date.