Utilities
electric x stormwater x wastewater x water
700 Wood St.
PO Box 580
Fort Collins, CO 80522
970.221.6700
970.221.6619 fax x 970.224.6003 TDD
[email protected] x fcgov.com/utilities
Winter Quarter Wastewater Billing Application
Commercial customers may be eligible for monthly wastewater billing based on their winter
quarter average (WQA). WQA is the average of water consumption shown on the January,
February and March bills and is updated annually in April. The minimum WQA is 6,000
gallons.
Date: _______________
Name on Account: ______________________________________
Address: _________________________________ Account #: _________________________
Type of Business(es) ____________________________________________________________
Contact Person: ____________________ Phone: ____________ Email ___________________
Indoor Water Use
Various types of water use occurring in the building. Please check all uses that apply.
Kitchen facilities
Commercial dishwasher or laundry
Lunchroom
Water-cooled equipment
Water-cooled air conditioning system
Cooling tower
Seasonal uses, please specify ____________________________________________
Outdoor Water Use
Does this account supply water for landscape watering?
Yes
No
don’t know
If yes, estimate in square feet or acres, the amount of landscape irrigated ___________________
List other outdoor uses ___________________________________________________________
Return completed form to:
City of Fort Collins Utilities
Attn: Mary Young
P.O. Box 580
Fort Collins, CO 80522
For Utilities Use:
Approved
Not Approved
By ________________________ Date ____________
Comments ____________________________________________________________________
_____________________________________________________________________