Leak Adjustment Form

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The City of Franklin adjusts water/sewer bills for leaks to customer-owned water distribution systems as a courtesy.  The customer is responsible for paying for water delivered to the customer at the meter hand-off and for sewer charges resulting from the water delivery.

 

Please answer the following questions for determination of eligibility for a leak adjustment.

1

Who provides your water?

Who provides your water?
2

If water provided by MVUD, HB&TS, or Milcrofton, please include water adjustment documentation.

3

What is your account number?

 *
4

What is the address where the leak occurred?

5
What type of leak occurred? Please check one:
What type of leak occurred? Please check one:
6

Date of repair:

7

Please check one and attach copy of receipt:

Please check one and attach copy of receipt:
8

Attach receipt:

9

I certify that all of the above information is correct and the leakage at the above address has been repaired.  I understand that it is the City of Franklin policy that I am entitled to only one leak adjustment on my account in a 12 month period.  No adjustment will be made for leaks that occur within 12 months of the date of repair and that any adjustments made on my behalf will be in accordance to the City of Franklin leak adjustment policy.  I acknowledge that it is my responsibility to maintain the water distribution system on my property.  Failure to properly maintain my water distribution system may result in no adjustments for leaks.  Typing name below will serve as your electronic signature.

  1. To receive a copy of your submission, please fill out your email address below and submit.