ROADWAY MAINTENANCE FEE (RMF)
CORRECTION / APPEAL REQUEST FORM
NAME: ________________________________________ ACCOUNT NUMBER:______________________
ADDRESS: ________________________________________________________________________________
PHONE: ____________________________________ EMAIL: ___________________________
TYPE OF SERVICE (Check one):
____ Sin
gle Family Residential ____ Multi-family Residential (Individually Metered)
____ Multi-family Residential (Master-metered) ____ Non-Residential
APPEALS
_____ 2. The Roadway Maintenance Fee was assessed in duplicate on multiple accounts for the same Benefitted Property
_____ 1. Property is exempt property under Section J of the Ordinance.
_____ characterization such as land use, building square footage or other relevant property characterization (see below)
_____ 5. The Roadway Mainteance Fee is assessed for a Benefitted Property unaffiliated to this Utility account
_____ 6
. Other.
Describe: ___________________________________________________________________
_____ 3. Property is outside city limits and should not be billed a Roadway Maintenance Fee.
(Continued on back.)
4. The Roadway Mainteance Fee assessed this property is incorrect due to improper property
If you are APPEALLING IMPROPER PROPERTY CHARACTERIZATION, please answer the following
questions
in order that we may better research your appeal:
II.
_____ 1. The number of dwelling units billed is incorrect (Multi-family/Master-metered
only)
______ Billed dwelling units
_____ 2. This property is adjacent to my location, has the same owner, was billed to me, but is not being used by me or my
my business, OR I own this property, but the
fee should be billed to someone else.
_____ 3. This property is adjacent to my location, has the same owner, was billed to me, but is vacant.
_____ Correct dwelling units*
*Certified documentation from a
Texas Registered Design Professional to include an engineer, architect or land surveyor required
Name of business/resident using property : __________________________________________
Billing address: ______________________________________
SUBMIT
RESET
III.
If you are APPEALLING your LAND USE DESIGNATION, please answer the following questions in
order that we may better research your appeal:
a) Hours of op
eration: ________________________ b) Drive- through? ______Yes _____ No
c) Do you sell it
ems at your location? _____ Yes _____ No
If yes, what
do you sell? _______________________________________________________________
d) Do you service o
r repair items at your location? _____ Yes _____ No
If yes, what
do you service or repair? _____________________________________________________
e) Do you manufa
cture or assemble items at your location? _____ Yes _____ No
If yes, what do you manufacture or assemble?_______________________________________________
f) Do you rent equ
ipment? _____ Yes _____ No
If yes, what
kind of equipment do you rent? ________________________________________________
g) Is your busines
s or organization in the Recreation Sector? _____ Yes _____ No
If the answer isYes, please list some of the activities at your location:
___________________________________________________________________________________
___________________________________________________________________________________
h) Is your busines
s or organization in the Service Sector? _____ Yes _____ No
If the answer isYes, please list some of the services you provide:
___________________________________________________________________________________
___________________________________________________________________________________
i) Is your busin
ess or organization in the Industrial Sector? _____ Yes _____ No
If the answer isYes, please indicate your industry:
___________________________________________________________________________________
___________________________________________________________________________________
j.) Are there other businesses at the same location as you? _____ Yes _____ No
Please provide examples of some of the other businesses at your location:
___________________________________________________________________________________
IV.
Please provide any other information you think might be useful for us to consider for your APPEAL
request:
____________________________
_______________________________________________________
___________________________________________________________________________________
APPLICANT SIGNATURE REQUIRED:
_____________________________________ ____________________________
Signature Date
Completed forms may be mailed to: UCS RMF Appeals, 310 Krenek Tap Rd, PO Box 10230, College Station, TX 77840
FOR INTERNAL USE ONLY
Date Received
Contacted (Y/N)
(A)pproved/(D)enied
Reviewed: ______
Date Customer Notified Date System Updated
UCS:
Fiscal Services:
click to sign
signature
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