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Traffic marking and striping is scheduled June 18-22 on Elden Street between Herndon Parkway and Sterling Road, resulting in periodic lane closures. Thank you for your patience.

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Water Leak Adjustment Application

Please correct the field(s) marked in red below:

In the event a customer has an unusually high bill as a result of a loss caused by a leak, a courtesy leak adjustment may be granted.

Please see Town Code Section 74-424 for more information.

To be eligible for an adjustment, the customer must:

1. Promptly and properly repair the leak within 10 days of discovery.
2. Provide written proof of repairs to the Town of Herndon in the form of receipts or an invoice.
3. Not have received such a credit during the five years preceding the date of discovery of the water service leak.

No credit shall be allowed for the period beginning ten (10) days after the date the water customer discovered such leak.

Personal Information

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Personal Information

Type of Leak:

Type of Leak:
If other, please explain:

Attach proof of repairs in the form of receipts or an invoice. (Please upload your documents below.)

Attach proof of repairs in the form of receipts or an invoice. (Please upload your documents below.)

 

By signing this document, I am requesting a credit to my/my tenant's water bill.  I understand this option is only available once every five years.

Typing your name in the space below serves as your electronic signature.

 *
By signing this document, I am requesting a credit to my/my tenant's water bill. I understand this option is only available once every five years. Typing your name in the space below serves as your electronic signature.
  1. To receive a copy of your submission, please fill out your email address below and submit.