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2. 
3. City of Longwood
   POOL - SEWER ADJUSTMENT FORM
5. IS YOUR ACCOUNT SETUP FOR AUTO DRAFT PAYMENTS?*

   1. YES
   2. NO
7. To receive a pool sewer adjustment your consumption must be above an average amount for the account (12 month average history). One sewer credit in a twelve month period is allowed for filling a pool.
9. Applicant Name
11. Todays Date
13. Service Address
15. Account Number
17. Date the pool was filled
19. Gallons used (per thousand)
21. Applicant Signature
23. Phone Number
Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field