Leak Adjustment Request

PLEASE NOTE: Completion of this request does not guarantee an adjustment will be made to your bill. The account must remain current to avoid additional service charges. City staff will contact you once the review is complete. Please allow up to 2 weeks to process (however, you will be notified before then of status). 

Per the Code of Ordinances, adjustments may be made for underground leaks between the meter and the structure. After the leak has been repaired, please provide receipts and images of the leak to the City Hall. An adjustment up to 50% of the estimated excess consumption due to leakage, for no more than the last billing period may be allowed. Adjustments are not permitted due to leaking plumbing fixtures or the apparent continued waste of water due to a negligent failure to repair.

Please fill in the form below and submit. Submission MUST include any receipts for repair (including purchase of supplies) and photos showing leak and repair.

Date Repaired
This could be a copy of plumber’s bills, receipts for parts, or pictures & additional information as to why receipts were not obtained for the repair of the leak.
Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png txt pdf doc docx.
This could be a copy of plumber’s bills, receipts for parts, or pictures & additional information as to why receipts were not obtained for the repair of the leak.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt pdf doc docx.
This could be a copy of plumber’s bills, receipts for parts, or pictures & additional information as to why receipts were not obtained for the repair of the leak.
Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png txt rtf pdf doc docx.
TERMS AND CONDITIONS
Electronic signature agreement. By typing your name in the signature block and selecting the "I Accept" button, you are signing this agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions. You further agree that your use of a key pad, mouse, or other device to select an item, button, icon or similar act/action, or in accessing or making any transaction regarding any agreement, acknowledgement, consent terms, disclosures, or conditions constitutes your signature (hereafter referred to as "E-Signature"), acceptance and agreement as if actually signed by you in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature. You also represent that you are authorized to enter into this Agreement for all persons who own or are authorized to access any of your accounts and that such persons will be bound by the terms of this Agreement.
I Accept: *
Date Signed
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