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<br />GRAND JUNCTION RESIDENTIAL RETROFIT PROJECT <br />PARTICIPATION AGREEMENT <br /> <br />Please answer the following questions and return to: <br />Grand Junction Utilities Department <br />250 N. 5th Street <br />Grand Junction, CO 81501 <br /> <br />You will be notified by mail and provided with detailed information if selected for <br />project participation. Please know that all water conservation devices will be delivered to <br />you free of charge and assistance in installation provided. We ask that you agree to install <br />devices in all toilets and showers for the duration of the study period and that you agree to <br />have your water and energy use evaluated. Monthly utility usage will be obtained through <br />Public Service Company and the city's water billing division. <br /> <br />1. Do you currently own or rent your home? <br />OWN RENT <br /> <br />2. Have you lived in this home for the past 3 years or more? <br />YES NO <br /> <br />3. How is your hot water heated? <br />GAS ELECTRIC <br /> <br />4. How many toilets does your home have? <br /> <br />5. How many showers does your home have? <br /> <br />6. Do you currently have any water conserving plumbing devices installed? <br />YES NO <br /> <br />NAME <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />SIGNATURE <br /> <br />I understand that by signing this agreement, I give consent to have my water and <br />energy consumption evaluated throughout the duration of the study. As a project participant <br />I will also agree to keep all water conserving devices installed throughout the 18 month <br />study period. <br /> <br />- <br />