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Irrigation Ban Waiver Request

NEED JOTFORM 
For Commercial, Industrial, and Institutional Customers only

Webform October 27, 2022

This form is intended to be used to obtain general information. 

Information about how EMWD will use your information can be found within EMWD’s Privacy Policy.

This form is to request a waiver for the enforcement of the State irrigation ban of nonfunctional turf. If you believe your property qualifies under the specified exceptions, you must complete and submit this form. Waiver requests are subject to verification by EMWD. 

Name: * 
Account Number: * 
Service Address: * 

Exceptions to the State Ban of Irrigation for Nonfunctional Turf: *

 No Nonfunctional Turf on Property
 Nonfunctional Turf is on Same Irrigation Valve as Trees/Shrubs/Perennial Plants
 All Landscaping is Irrigated with Recycled Water
 No Longer Irrigating Nonfunctional Turf/Removed Nonfunctional Turf

If you are no longer irrigating or have removed or replaced nonfunctional turf from your property, please let us know how many square feet.

Amount of Nonfunctional Turf Removed or Replaced: 
Amount of Nonfunctional Turf No Longer Irrigating: 
Please upload a photo of your current irrigated area: * 

EMWD will review your request and contact you with any questions, to schedule a site visit, or to confirm your waiver status.

Email address: * 

Daytime Phone (between 8 a.m. and 5 p.m.): * 

Include ext. (if application)

Electronic Signature: *

 By checking this box, I certify that I have completed this form and affirm that I am the above account holder and the information contained herein, including any and all additional documentation submitted via email, fax or mail, is complete and accurate. I further understand that all waiver requests are subject to change, and I may be liable for back charges for providing false information.