Abatement Request Form

Account and Applicant Details
Account Number*
As it appears on your bill
Last Name or Business Name*
As it appears on your bill
Service Address*
This is the address that is serviced
Phone Number*

Area CodePhone Number
E-mail*
Number of Bedrooms at Property Served*

Abatement Type

Please select an abatement type from the following list. Requests for seasonal water use abatements for 2nd meters must use the 2nd meter abatement request form.

Only three types of general abatements are considered:

Pool Abatements - For abatements of one-time pool fill-ups. This adjustment is for permanently installed in- ground or above ground pools only. This does not apply to temporary pools or seasonal refilling or topping off. Please attach a photo of the pool and provide pool dimensions as part of your submission below. Attach copies of receipts for new pool, pool liner replacement, or leak service.

Leak and Meter Abatements - For abatements of water volumes caused by leaks that were not discharged to the sewer. This includes leaks on outdoor water pipes or on pipes prior to plumbing fixtures. This does not include leaking toilet valves or faucets. Attach documentation from water department and describe the reason for the abatement including any calculations as part of your submission below.

Miscellaneous One-Time Abatements - For all other one-time abatements and billing adjustments. These will be considered on a case-by-case basis and any adjustment granted will be based on the circumstances described by the customer and by review of historical usage data. Describe the reason for the abatement including any calculations as part of your submission below.
Contested Period*

MonthDayYear
Type of Abatement Requested*
Type of Pool*

Pool Dimensions

Enter in the dimensions of your pool in terms of feet. These dimensions are used to determine the volume of your pool.
Length of Pool (A)*
Width of Pool (B)*
Depth of Shallow End*
Depth of Deep End*
Diameter of Pool (D)*
Depth of Pool*
Round Pool Volume ( CF )
Rectangular Pool Volume ( CF )
Leak and Meter Abatement Details
Please provide a written statement describing why you believe an abatement is owed on this account for abatements of water volumes caused by leaks that were not discharged to the sewer. Describe in detaul any leaks on outdoor water pipes or on pipes between meter and plumbing fixtures. This does not include leaking toilet valves or faucets. Attach documentation from water department. Please be descriptive as possible and provide all calculations used to determine the amount of your request and attach relative documents.
Details
Please provide a written statement describing why you believe an abatement is owed on this account. Please be descriptive as possible, provide all calculations used to determine the amount of your request and attach any relevant documents, photo's etc.
Pool Details
Provide any other details about this pool fillup request that may be relevant. For irregular shaped pools, please provide a written description of your pool including any relative dimensions, depth, and the volume. If available, please also attach a photo of the pool with the attachment button below.
Written Details*
Abatement Volume Requested*
This is the volume of water in cubic feet which you are requesting be deducted from your bill
Attach Documents

Choose Files
Upload any documents that support your request, such as photos, adjusted water bills, pool receipts, etc. Cancelof

Terms and Conditions

The filing of this form does not guarantee that your abatement will be granted.

The filing of this form does not relieve the applicant of the responsibility to pay the sewer usage bill in full by the due date specified.

Abatements will be considered by the Commission on a case-by-case basis.

Approved abatements will be reflected as an account credit in the next billing period.
Account Status*

All amounts due on that account, including interest and penalties, for all billing periods prior to the contested period covered by the abatement or adjustment application have been paid in full.
Submission*

By checking this box and submitting this form, I acknowledge that I have read the LSDC abatement policy and that I am digitally signing this submission and certify under the pains and penalties of perjury that the information as contained herein is true and correct. I am additionally consenting for my email address to be added to the LSDC's online account access system.

Calculated Volume
Dimensions text:
Should be Empty: