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Residential Variance Form

  1. If you believe you need an increased water budget based on the criteria listed below, please complete this form. The water budget tiered rate billing system is designed to serve as a tool to help you identify problems such as leaks or over-watering. Using water efficiently helps RCWD keep water rates low by reducing purchases of expensive water from outside the local area. Variances may be approved for any of the following reasons and are subject to periodic review by RCWD. All variances are subject to change and you may be liable for back charges for providing false information. Please allow 4 to 6 weeks to process your request for variance. Variances will be effective beginning with first complete billing cycle after the date they are approved.

  2. Please include your landscape area sketch with dimensions in feet & total area in square feet. Include pool surface area.

  3. Enter total number of persons and submit a copy of facility license.

  4. Attach verifiable medical documentation.

  5. Please attach proof of large animals (photos, etc.)

  6. There may be an instance where an increased allocation on a permanent or temporary basis may be appropriate. If you believe this is the case, please provide the details in the box above and attach any documentation you may have.

  7. Electronic Signature:*

  8. Leave This Blank:

  9. This field is not part of the form submission.