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Name: aa nday frepartis Address: _— y bea NN Account Number: If determined eligible for Leak Forgiv ene ss Progr: am: Eligible @LY N Leak Fixed: Febuacy Sewer Abatement] Nv Billing Period: _ 37 3!-# Current Bill: Water $: S27. BA + Sewer $: S2A¥.77 =Total Bill 5 ERR 1358 4 Average Consumption (last 4 qtr. average prior to current leak bill): 1b 532 ae ns Average Water/Sewer Bill Totals (last 4 qtr. average prior to current lek bill): Current Bill Consumption (gallons):__ (24,590 Leak Forgiveness Calculations: Current Consumption - Average Consumption =__! a 768 [1000=__! IA .16 124 seo / b 532 (Leak Forgiveness Eligibility) (Units) ($3.02/unit reduction) 3 y J i ($2.01/ unit reduction) oy, 4 4 Ay Unit x 50% Water Rate Reduction $ a Unit x 50% Sever Rate Reduction $ ATO Current Water Bill Portion § $ 50 tod Current Sever BillPortion $ D2 5.77 Water Forgiveness g__ FORTS STi! Sewer Forgiveness ¢ DORR sO Total Water Adjusted Bil g___‘“167 3% Total Sewer Adjusted BI] = $__ 30 1.73 Current Bill: $. -Water Forgiveness $ 34f 1b -Sewer Forgiveness $ 227 S 1 TOTAL Adjusted Bill $ 167,54) Total Leak Forgiveness $ 569.20 Recommended by Water Hearing Committee on Water Hearing Village Board Liaison Signature