Note: This submittal form is not the application. After completing this online request form, your account information will be verified, and an application will be sent to you through the mail. Please allow up to 10 business days for receipt of application by mail. Or if you would like to receive the application via email, provide us with your email address on this form and we will email you the application.

* Fields are required

Rebate Type Xeriscape 

Recirculator

Irrigation Controller/Timer

New Home Xeriscape

High Efficiency Toilet
Account Number *   (located on your utility bill)
Use format 000xxxxx-xx (ex:00012345-01)
NOTE: You must enter the correct account number or your request will not be processed.
Name on Account *  
Applicant's
First Name		 *  
Applicant's
Last Name		 *  
Account
Street Address		 *  
Account City *
Account
Zip Code		 *  
Is mailing address the same as property address? * Yes           No

If NO, YOU MUST fill out the following section.
Mailing Address
City
State
Zip Code
If you would like to receive an application via email, please provide your email address.
Phone *
Other Phone
Water Provider *  
Account Type *  
Property Type *