Request for Variance from Drought Contingency Plan

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If you prefer, you may instead print and mail or deliver this form. [ Printable Version ]

Application is hereby made for a variance to the Lakeway MUD Drought Contingency Plan as described below:

Customer Name*

First Last

Service Address*

Street Address City State ZIP Code

Mailing Address

Same as Service Address?

Street Address Address Line 2 City State ZIP Code

Phone

Purpose of the water use:

Specific provision of the Plan from which applicant is requesting relief:

Detailed statement as to how the specific provision of the Plan adversely affects applicant :

Description of the relief requested:

Period of time for which the variance is sought:

Alternative water use restrictions or other measures the applicant is taking or proposes to take:

Other pertinent information:

The undersigned Applicant understands that the processing of this Application will be handled in accordance with the Procedure for Requesting Variances to the Drought Contingency Plan established by Lakeway MUD. It is further understood that acceptance of this application does not obligate LMUD to approve the variance

Signature

Date

Phone

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Lakeway Municipal Utility District

Customer Support

Quality Matters

Six Years