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LEAK FORGIVNESS FORM
LEAK FORGIVNESS FORM
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Water Forgiveness Form
It is the City of Monticello's policy to grant a billing adjustment, or leak forgiveness, for EXTRAORDINARY and non-recurrent plumbing problems on the customers side of meter.
The consumption of the leak or extraordinary use must be at least 200% greater than the highest monthly consumption for the (12) months prior to the leak. An adjustment will only be given for a leak that has been REPAIRED. Any other problem causing extraordinarily high consumption that has been identified and resolved may be considered on a case-by-case basis and only one request per 12-month period be considered. The adjustment will be figured based on high usage for the (12) months prior to the leak and adding 50% to that amount.
Please fill in the form below and return to the City Offices
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Date
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Name
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Phone Number
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Account Number
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Address
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Date leak was discovered
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Date leak was repaired
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Location of leak or Cause of Extraordinary Consumption
Please Choose One
Secondary
Culinary
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Repair Information
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Signature and Date
Monticello City Office Use Below
Received by
Customer Contacted
Month
Billed Amount
Adjusted Bill
Forgiveness Amount
Approved By
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