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Leak Adjustment Request

Steps

  1. 1. Step One
  2. 2. Step Two
  • Step One

    1. Instructions

      This leak adjustment request must be filled out by the owner of the property. If you are a tenant, please contact the owner and ask them to fill out this form.

    2. Resolution Verification*

      I have read and understand City Resolution no. 655.

    3. Notification of Leak*

      I certify that I have notified the city of the leak within a one month period of the discovery of the leak.

    4. Fixed Leak*

      I certify that the leak on the service address listed below was repaired within ten (10) days of notification or discovery of leak.

    5. Property Owner Verification*

      I certify that I am the property owner.