Fillable Application for Bernalillo County Rain Barrel Program (Bernalillo County)

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Application for Bernalillo County Rain Barrel Program (Bernalillo County)

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Rain Barrel Application, Version 06.26.20 1
Application for Bernalillo County Rain Barrel Program
Participants in the Rain Barrel Program receive either two free 55-gallon rain barrels, or one $80 100-gallon
rain barrel. The program also provides a free Residential Water Audit and a Water Conservation Kit that
includes a low-flow showerhead and faucet aerators. Property owners who do NOT receive water service
from the Albuquerque Bernalillo County Water Utility Authority (ABCWUA) are eligible.
Please submit completed application by email to vcarrillo@bernco.gov, fax to 505-848-1510, or mail to the
Bernalillo County Water Conservation Program, 2400 Broadway SE, Albuquerque, NM, 87102.
Property Owner Information
Name ______________________________________________________________
Address ____________________________________________________________
Phone & Alternate Phone ______________________________________________
Email ______________________________________________________________
Property Information
Address where rain barrel(s) will be used:
___________________________________________________________________
(Must be completed-failure to accurately complete will result in automatic denial of the application)
Parcel Number _______________________________________________________
(Found on Tax Bill)
If applicant does not own the property where the rain barrel(s) are to be used, the applicant is responsible for
obtaining the owner’s permission and signature or the application will be automatically denied.
Conditions And Applicant Responsibilities (Please read and indicate if agreed)
1. The Rain Barrel Program offers two rain barrel options (photographs and specifications are available at:
http://www.bernco.gov/public-works/rain-barrel-program.aspx). Please select the option you prefer:
Two free 55-gallons rain barrels
One $80 100-gallon rain barrel
Staff will provide a receipt for any payment made to the County (If you do not receive a receipt, please
contact the Water Conservation Program Manager at 848-1500).
2. I understand that the work performed for the Residential Water Audit will be performed at the discretion
of the County, and if performed, will be at no cost to me. I authorize access to the above listed address for
Rain Barrel Application, Version 06.26.20 2
the purpose of this free service. I hereby agree to hold harmless and indemnify the County, its officers,
agents, and employees from and against any and all liability, suits, actions, claims, damages, attorney’s fees,
and costs arising out of or resulting from the Residential Water Audit and/or any water-saving devices
received.
_________ (Initial)
3. In acquiring a rain barrel(s) from Bernalillo County, I acknowledge that the County is not responsible for
any problem resulting from the installation, storage or use of the rain barrel(s). I understand that the proper
installation and use of the rain barrel(s) is solely my responsibility. I hereby agree to hold harmless and
indemnify the County, its officers, agents, and employees from and against any and all liability, suits,
actions, claims, damages, attorney’s fees, and costs arising out of or resulting from the installation, storage,
use and maintenance of a rain barrel(s) acquired through the County.
_________ (Initial)
4. I understand that if the property where the rain barrel(s) are to be installed has any unresolved issues
with any Bernalillo County departments, such as but not limited to building and zoning or environment
health code violations, the issues must be resolved before the rain barrel(s) can be provided.
_________ (Initial)
5. I understand that this program is dependent on funding. I understand that applications will be processed
and completed on a first-come first-served basis and that I may not receive services if there is not sufficient
funding.
_________ (Initial)
By signing, I certify that I have read, understand and agree to honor the above conditions and
responsibilities.
_____________________________________________________ ____________________
Signature of Property Owner Date
For Office Use Only
Applicant Eligibility Verified By: Date:
_________________________________________________ ________________________
Property ownership verified through County Treasurer tax records?
Property taxes current according to County Treasurer tax records?
Property is not served by ABCWUA water?
Property is free from legal encumbrances and in compliance with all County codes?
Property owner has not previously received a rain barrel(s) through the Rain Barrel Program?
Application Approved By: Date:
_________________________________________________ ________________________
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Application for Bernalillo County Rain Barrel Program (Bernalillo County)

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Completed 2 August 2020

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