Capital Maintenance Fee Adjustment Form

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Capital Maintenance Fee Adjustment Application

Use the form below to apply for a Capital Maintenance Fee (CMF) Adjustment.

Name of Property Owner

Email Address

Service Number

See Water Bill

Phone Number

Address

City/Town

State/Province

ZIP/Postal Code

If 2nd unit (aka Accessory Dwelling Unit), please complete Boxes A and B:

Box A

Attached

Detached

Box B

Size in square feet:

Number of Living Units:

Irrigation System

Yes

If yes, please provide the approximate area of lawn that is irrigated.

Square Feet of Lawn:

Current Meter Size

Does the structure have a fire sprinkler system installed?

Yes

If yes, please attach additional supporting documentation such as: The Building Dept. final inspection card, or letter from the fire sprinkler installer. If no, you may qualify for a meter reduction. Please do not complete this form. Instead, submit a completed “Meter Reduction Worksheet"

Upload Supporting Documentation

Unlimited number of files can be uploaded to this field.
85 MB limit.
Allowed types: txt, pdf, doc, docx, .

Water-Using Fixtures

You must provide information about your residential or commercial project water-using fixture demand to help us determine the meter size. You can do so by either entering the Total Fixture Unit Demand for all of your fixtures or use the Water Supply Fixture Unit (WSFU) tables to calculate the total demand.

Residential Fixtures

If you know your total water demand in gallons per minute, please enter it here.

Total Water Demand

Residential Fixtures	Number	WSFU	WSFU Total
Kitchen sink	kitchen sink number	ks wsfu	ks wsfu total
Dishwasher	dishwasher number	mst_2_wsfu	mst_2_wsfu_total
Bar sink	bar sink number	mst_4_wsfu	mst_4_wsfu_total
Bathroom sink	bathroom sink number	mst_5_wsfu	mst_5_wsfu_total
Shower	shower number	mst_6_wsfu	mst_6_wsfu_total
Tub/shower combo	tub shower combo number	mst_7_wsfu	mst_7_wsfu_total
Toilet	toilet number	mst_8_wsfu	mst_8_wsfu_total
Lawn sprinkler heads *	lawn sprinkler number	mst_9_wsfu	mst_9_wsfu_total
Washing machine	washing machine number	mst_10_wsfu	mst_10_wsfu_total
Laundry sink	laundry sink number	mst_11_wsfu	mst_11_wsfu_total
1st Hose bib	1st hose bib number	mst_12_wsfu	mst_12_wsfu_total
Hose bib additional	mst_13_number	mst_13_wsfu	mst_13_wsfu_total
Total Residential WSFU			mst_grand_total

* Enter the maximum number of lawn sprinkler heads used at one time.

Electronic Signature

Name of Applicant

Date

Electronic Signature

Yes

By typing the name above, the property owner hereby certifies under penalty of perjury that the information provided in this application is true and correct.