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Leak Adjustment Request

  1. 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 no. 655*

  3. Notification of leak*

  4. Notification of Leak *

  5. Supporting Documents*

  6. 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 Tami Wood: Email:; Mail: PO Box 987; Snoqualmie 98065; In Person at City Hall: 38624 SE River St; Snoqualmie 98065

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

  8. 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.

  9. If you have questions, please email Tami Wood:

  10. Leave This Blank:

  11. This field is not part of the form submission.