Residential Water Budget Variance Request Form

This form is to request a water budget greater than the standard amount Corona DWP uses.  If you believe you need an increased water budget based on the criteria listed below, please complete and return this form in its entirety. Variances may be approved for any of the following reasons and are subject to periodic review. 
Preferred method of contact: *
I request an increased water budget for the following reason(s). Check all that apply: *

More than 4 full-time residents in the household.
Please provide the first and last names, relationship, and birth date of each resident in the household.  You may be required to submit documentation for each person to substantiate the claim if necessary. For households with more than 8 full-time residents, please send an email to with the name, relationship and birth date for each additional resident. You will be required to renew this request every 5 years.

Licensed Child or Adult Day Care Facility (in a residential unit)
 Please submit a copy of a valid Family Child Care Home license or Adult Day Care license issued by the California Department of Social Services. You will be required to renew this request every 5 years.

Irrigated landscape area greater than Corona DWP estimate.  
After submitting this form, please send a property sketch with dimensions on 8.5” x 11” paper to

Pool filled from empty.
A one-time adjustment calculated at the outdoor rate granted no more than once every 5 years for routine maintenance. If the pool is required to be drained to repair a leak or damage, please upload a copy of the invoice. 

Medical Needs
In addition to this form, you will need to upload a clear photo or scan of your medical documentation. This documentation does not need to state the medical reason for the increased budget.  You must renew this request every 5 years.

Other circumstances
There are instances when an increased budget on a permanent or temporary basis is appropriate. If you believe that is your case, please provide the details in the fields below and upload a clear scan or photograph of documentation  (receipts for parts purchased/invoices). If there is no end or repair date, please note that in the comment field.

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