HomeMy WebLinkAboutApplicationForPoolAdjustmentAPPLICATION FOR POOL ADJUSTMENT
EMAIL utilitybill@oshkoshwi.gov PHONE 920-232-5325
To be considered for a pool adjustment the water bill must be current
(no past due balance). Only one pool filling will be adjusted in a year
and this includes partial fillings. The adjustment will appear on a future
bill. A pool adjustment means you will pay for the water used but not
the sewer portion of it. This pool adjustment application MUST be filled
out COMPLETELY and received at the Utility Accounting office (Room
106) in City Hall within 3 months of filling your pool.
Pool Permit #: _______________________________________
Account number: ____________________________________
Account name: ______________________________________
Address: ____________________________________________
Phone number: ______________________________________
Email address: _______________________________________
Date pool was filled: __________________________________
Beginning Reading: _____________ End Reading: __________
Pool Shape: _________________________________________
Length or Diameter: ______________ Width_______________
Depth shallow end: ___________ Depth deep end___________
Gallon capacity: ______________________________________
Did you fill from empty? ________________________________
If not how full? (exp ½ full): _____________________________