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4. Water Customer Information:
6. House #:*
7. Street Name:*
   -- Select One --Adams CourtAfton DriveAlcott DriveAllwood TerraceAlpine WayAmbrosia CourtAmelia AvenueAmherst PlaceApple Tree CourtArbor CourtArden RoadArgyle CourtArlington DriveArrow DriveArthur TerraceNorth Ashby AvenueSouth Ashby AvenueAshwood DriveAspen DriveAudobon RoadAvon AvenueBadger DriveBaker RoadBaldwin TerraceBalmoral DriveNorth Baums CourtSouth Baums CourtBeacon AvenueBeacon PlaceBear Brook CourtBear Brook LaneBeaufort AvenueBellacourt PlaceBelmont DriveBelvedere DriveBennington RoadBeresford LaneBerkeley PlaceBerkeley RoadBerkeley TerraceBerkshire RoadBeverly RoadBillingsley DriveBinghampton LaneBirch Tree LaneBirchwood DriveBlackstone DriveBonnyview DriveBorden PlaceBoulderwood DriveBowling DriveBoynton DriveBraeburn CourtBrandon AvenueBrayton RoadBrentwood DriveBreton PlaceBriar Cliff RoadBriggs CircleBrighton CourtBristol CourtBroadlawn DriveBroadlawn PlaceBrookside AvenueBrookside PlaceBrown CourtBrowning CourtBryant DriveBunyan DriveBurgandy CourtBurgandy DriveBurlington RoadBurnet StreetBurnet Hill RoadBushkill DriveByron PlaceCambridge RoadCamelot DriveCanoe Brook DriveCanterbury RoadCarillon CircleCarlisle DriveCarteret RoadCase TerraceCedar Gate CourtCedar Gate DriveCedar StreetNorth Cedar ParkwaySouth Cedar ParkwayEast Cedar StreetWest Cedar StreetCedar TerraceCentennial RoadChadwick RoadChampion BoulevardCharles StreetChaucer CourtChelsea DriveCherry Hill RoadChestnut StreetChetwynd TerraceCIT DriveClaremont AvenueCliffside DriveClover LaneCobblewood RoadCoddington TerraceCollins TerraceCollinwood AvenueColonial WayColumbia RoadConcord DriveCongressional ParkwayConsul RoadCornell DriveCornerstone WayCortland CourtCottage TerraceCountry Club CourtCountry Club RoadCountryside DriveCoventry RoadCreighton DriveCrescent RoadCrest TerraceCrestview Hill RoadCrossbrook PlaceCrossbrook RoadCrown CourtCulver RoadCyprus LaneDana DriveDarby TerraceDartmouth CourtDaven AvenueDawson TerraceDeal LaneDeerfield RoadDellmead DriveDemarest RoadDevonshire RoadDickinson LaneDisney PlaceDogwood TerraceDominion CourtDorothy AvenueDorrien RoadDorsa AvenueDougal AvenueDowning PlaceDriftwood DriveDrummond TerraceEast DriveEastbrook TerraceEdgemere RoadEdmonton CourtEisenhower ParkwayElizabeth AvenueElkin DriveElmwood CourtElmwood DriveEly CourtEmerson DriveEmpire DriveEndor WayEsplanade WayEssex CourtEton RoadEvergreen AvenueExecutive ParkwayFairfax DriveFalcon CourtFalcon RoadFawn DriveFellswood DriveFernwood RoadFieldstone DriveFilmore AvenueForce Hill RoadFordham PlaceFordham RoadForest StreetFoxcroft DriveFranklin AvenueFranklin PlaceFredon DriveFullerton PlaceGable WalkGala CourtGarnet TerraceGiacomo CourtGlannon RoadGlendale AvenueGoodhart DriveGorham AvenueGrand TerraceGrasmereCourtGraymoor RoadGreenwood CourtGrove TerraceHadrian DriveHamilton LaneHampton TerraceHaralson CourtHarding PlaceEast Harrison PlaceWest Harrison PlaceHarvard LaneHarvard PlaceHarvest LaneHastings LaneHavenwood DriveHawthorne DriveHazel AvenueHazelwood AvenueHearthstone TerraceHeather LaneHemlock RoadHemshire DriveHepworth StreetHerbert TerraceHeron RoadHickory PlaceHighland DriveHighview DriveHill StreetHillary CourtHillside AvenueNorth Hillside AvenueHillside TerraceEast Hobart Gap RoadWest Hobart Gap RoadHobson DriveHomestead TerraceHuntington RoadIndustrial ParkwayIntervale RoadIroquois DriveIrving AvenueJackson DriveJason LaneJefferson CourtJohn F Kennedy ParkwayKathay DriveKean CourtKearney TerraceKensington LaneKeyes RoadKeystone DriveKimball AvenueKingston DriveKinkead DriveKnollwood DriveKredel AvenueLafayette DriveLangtree DriveLargo LaneLarkspur PlaceLaurel AvenueLee RoadLenape RoadLexington DriveLincoln AvenueNorth Livingston AvenueSouth Livingston AvenueLockhern CourtLockhern DriveLocust PlaceLongacre DriveLongview RoadMacintosh CourtMacopin CourtMacopin DriveMadison CourtMadonna DriveManor RoadMansfield CourtMaple AvenueMaplewood DriveMarberne TerraceMarisa CourtMarlo RoadMartin RoadMayhew DriveMcCall AvenueEast McClellan AvenueWest McClellan AvenueMeadowbrook RoadMellon PlaceMelrose DriveMerian WayMichele LaneMicrolab RoadMidway DriveMillbrook CourtMillstone DriveNorth Mitchell AvenueSouth Mitchell AvenueMohawk DriveMonmouth CourtMontgomery RoadMorningside DriveMorton RoadMountain Ridge DriveMounthaven DriveEast Mount Pleasant AvenueWest Mount Pleasant AvenueMount Pleasant ParkwayMount Vernon ParkwayMurray CourtNaylon AvenueNaylon PlaceNorman CourtNorth DriveNorth Ridge RoadNorthfield CourtEast Northfield RoadWest Northfield RoadNotch Hill RoadNottingham RoadOak StreetOak Tree LaneOakmont CourtOakwood AvenueWest Oakwood AvenueOld Mount Pleasant AvenueOld RoadOld Short Hills RoadOrchard LaneOskar CourtOverlook RoadOxford DrivePage PlacePalmer DrivePark DriveParsonage Hill RoadPassaic AvenuePeachtree Hill RoadPebble Beach DrivePenny RoadPenwood RoadPine Valley RoadPitcairn RoadPittsfield CourtPlymouth DrivePointe Gate DrivePost LanePreston DrivePrinceton RoadProspect RoadPutnam RoadRainbow Ridge DriveRale TerraceRedwood RoadRegal BoulevardRelkin RoadRidge DriveRidgewood DriveRiker Hill RoadRobert Harp DriveRobin AvenueRockhill DriveRockledge DriveNorth Rockledge DriveRoosevelt TerraceRosedale TerraceRosewood CourtRoss RoadRossmore TerraceRoyal AvenueRumson RoadRutgers RoadSalem PlaceSandalwood DriveScarsdale DriveSchindler WayScotland DriveScott TerraceSeymour Schram LaneShadowlawn DriveSheffield CourtSherbrooke ParkwayEast Sherbrooke ParkwaySheridan RoadSherwood CourtShrewsbury DriveSidehill CourtSouth Orange AvenueSpalding DriveSparrow DriveSpier DriveSplit Rock RoadSpring RoadSpringbrook PlaceSpringbrook RoadSquier CourtSterling DriveStokes TerraceStoneham DriveStonehedge DriveStonewall DriveStony Hill PlaceStratford DriveSunset RoadSunshine LaneSurrey LaneSutton WaySwan RoadSycamore AvenueSycamore TerraceSykes AvenueSylvan CourtSymington AvenueTabor CourtTaconic RoadTaft CourtTamarack RoadTanger DriveTanglewood DriveTarlton DriveTemplar WayTerry TerraceThames DriveThurston DriveTiffany DriveTilden CourtTimber Hill DriveTorrance DriveTower RoadTown Center WayTrafalgar DriveTremont TerraceTrinity DriveTrocha AvenueTrombley DriveTroy DriveTudor TerraceTulane DriveTulip CourtTurlington CourtTuscan RoadTuxedo DriveTwilight CourtTwin Oak RoadValley View CourtVanderbilt DriveVentnor PlaceVere TerraceVictor AvenueVillage DriveVine StreetVirginia AvenueVista TerraceVolker LaneVolunteer WayWahler RoadWalnut StreetWalton LaneWardell RoadWashington CourtWayside PlaceWellington RoadWest DriveWest Lawn RoadWestgate RoadNorth Westgate RoadWestminster DriveWestmount DriveWhite Oak DriveWhittier WayWildwood AvenueWillow LaneWilshire DriveWilson TerraceWinans RoadWinchester RoadWindermere CourtWindsor CourtWingate DriveWinged Foot DriveWinston DriveWoodcrest DriveWoodland TerraceWychwood RoadWynnewood RoadYale CourtYorktown TerraceZahn Terrace

   Tip: Begin typing street name to filter list

9. Name:*
10. Phone Number:*
11. Email:*
15. Installer Information:
17. Installer's Name

    (Home Builder / Owner / Landscape Professional:)

    
    

18. Phone Number
19. License # (for irrigation professionals)
23. Smart Controller Information:
25. Verify WaterSense Compliance

    Please visit the EPA WaterSense website and confirm your product is listed prior to submitting the form.  If your product is not listed here you will not receive a flag. 

27. Manufacturer:*
28. Model #:*
29. Date (of Ownership):
    Date (of Ownership):
31. Number of Zones:*
32. On-Site Monitor/Sensor:*

    1. Yes
    2. No
33. Weather Data Subscription:*

    1. Yes
    2. No
34. Property Type (check one):*

    1. Single-Family:
    2. Multi-Family Dwelling:
    3. HOA (common area):
    4. Irrigation Meter (only):
38. Terms and Conditions:

40. I certify that this smart controller was purchased and installed at the address listed above. I understand that the installation of an approved smart controller does not guarantee a reduction in my water bill or my water usage. I agree to display my designated yard sign visible from the street to indicate the use of a smart controller. I understand that the sign belongs to the Township and may be removed for non-compliance. The Township of Livingston may deny any application that does not meet requirements. I certify that the above information on this application is true and correct to the best of my knowledge.

42. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
44. Electronic Signature*
45. Date:*
    Date:
Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit Submit and Print

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