HomeMy WebLinkAboutApplicationForLeakAdjustmentAPPLICATION FOR LEAK ADJUSTMENT
EMAIL utilitybill@oshkoshwi.gov PHONE 920-232-5325
This leak adjustment application MUST be filled out COMPLETELY and
received at the Utility Accounting office (Room 106) in City Hall within 3
months of the repair to be considered for a leak adjustment credit. The
credit will only apply to the last three billing periods ending with the
repair date.
Account number: ____________________________________
Applicant name: ______________________________________
Address: ____________________________________________
Phone number: ______________________________________
Email address: _______________________________________
Date leak was repaired: ________________________________
Type of leak or repair: _________________________________
Do you know how long the leak was going on? ______________
Where did the water go? (exp down drain) _________________
Who did the repair? ___________________________________
Number of people living here? __________________________
Any water changes in the last year or going forward for the next
month? _____________________________________________
(exp: occupancy, water savers installed, watering)