Form Center • Leak Adjustment Request

Service Address*

Understanding of Supporting Documents*

I understand that I must provide supporting documentation that the leak was fixed. If I do not provide documentation, I may not receive the leak adjustment.

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Supporting Documents Upload

Please attach any supporting documents and/or receipts that verify your leak has been repaired. If you cannot scan and upload them, please send to Heather Florida via email instead: hflorida@snoqualmiewa.gov. Or you may mail to PO Box 987; Snoqualmie 98065. You may also drop in the secure drop box outside the front door of City Hall at 38624 SE River St; Snoqualmie 98065

Notes or explanation for Utility Billing Clerk*

Please explain how you have or will be submitting your supporting documents that the leak was fixed.

Signature*

I am the owner of the above named property and the leak on the service address was repaired within ten (10) days of notification of leak. I have read and understand City Resolution no. 655 and certify that all the information contained herein is accurate, to the best of my knowledge.

Please provide an email address for questions about your request:*

If you have questions, please email Heather Florida: hflorida@snoqualmiewa.gov

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