Household Population Adjustment Affidavit Application

Request for increased water budget due to household population adjustment.

Process and impacts on your account:

Purpose

The indoor water budget is based on average consumption for a three person household. The idoor water budget for each residence is 12,000 gallons bimonthly, however, the average home has an indoor usage of 9,000 gallons bimonthly. In some cases the household population may create a need for additional water budget. This application is a request for an increase to indoor water budget due to additional YEAR ROUND household population. (Irrigation budgets are seasonal and allocated based on lot size in addition to the indoor budget.)

Process

If you would like to request an increase in water budget based on your household population, you must first read through the impacts to your account then complete the online application below.

Impact

The base water budget for indoor use is 12,000 gallons bimonthly. This is based on the average Highlands Ranch household population of 3 persons. Additional permanent residents over 3 may be the basis for an increase in the base water budget for indoor use of 3,000 gallons per month.

However, the wastewater fee charged for the residence WILL BE INCREASED because it also is calculated based on a 3 person household. Using more water indoors means more wastewater will be generated.

*Important Note: The increase in the water budget for household population adjustment purposes will lead to an increased wastewater charge as well. Therefore, if your actual indoor water use is less than the estimated break-even usage, you will end up paying more in wastewater charges without offsetting savings on water charges. For this reason, you should carefully consider whether your indoor water use would justify a net savings through this program. Email the water billing department with any questions about your history of water usage to help you make this decision.

Complete the form below to request a household population adjustment

Full Name

First Name (required)

Last Name (required)

Email (required)

Account Number (required)

Name on account (if different than above)

First Name

Last Name

Property Address

Street Number and Name (required)

City (required)

State/Province/Region (required)

Postal/Zip Code (required)

Billing address (if different than above)

Street Number and Name

City

State/Province/Region

Postal/Zip Code

By providing your name below, you certify the above information and acknowledge that: (required)

I am applying or reapplying for an annual increased water budget because the above address is the primary year round residence for the following number of persons

• The granting of an increase in water budget for this purpose is subject to annual renewal.

• I have read and understand the information below concerning the impact on wastewater charges.

• The information contained in this form is subject to audit. Should an audit be necessary, applicant agrees to provide acceptable documentation of the actual household population. Such documentation may include, but is not limited to, copies of Federal 1040 tax forms, driver's licenses or other records which show proof of residence.

• If any of the information supplied on this application by the applicant is found to be false, the fees and charges will be adjusted retroactively to the date of this application and appropriate fees and charges added to the next utility services bill for the address.

• Applicant understands that water usage in excess of the assigned water budget may result in significantly higher costs as an incentive to use water wisely.

Total household population (required)

Less 3 persons in the base water budget = number of persons to increase (required)

Full Name

First Name (required)

Last Name (required)

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Process and impacts on your account:

Purpose

Process

Impact

Complete the form below to request a household population adjustment

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