Form Center

Disclaimer: Online forms are designed for online submittal and do not convert to "printer-friendly" forms. Enclosed in each form are print instructions to address how to achieve the best printing results. Alternatively you may download and print the PDF version of the form - click the PDF icon below the form.
By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Lakehaven Leak Adjustment Request Form

  1. Lakehaven Water and Sewer District
    31627 1st Avenue S
    P.O. Box 4249
    Federal Way, WA 98063-4249
    Federal Way: 253-941-1516
    Tacoma: 253-927-2922
    Fax: 253-839-9738
  2. Please provide your email address if you would like us to respond via email.

    (If you would like a copy of this form emailed to you, you must enter your email again in the submission section of this form.)
  3. Describe where the water leak was located and what steps you took to resolve the problem? e.g. "Toilet in master bath was leaking, replaced toilet."
  4. Leak Adjustment Information
    If you are signed up for auto-pay please call Customer Service 253-941-1516 to avoid excess charges.

    Adjustment Calculations: 50% of the difference between the actual CCF (100 cubic feet) of water billed and the “averaged” CCF of water consumed during the same billing period of the previous year – not including the base rate.

    Adjustment Period:Maximum 3 billing cycles. One leak adjustment allowed every 2 years.
  5. Return Your Request
    Return your request along with any receipts that support your entitlement to this leak adjustment via one of the following options:
    (This information can be found at the top of the form)
  6. Signature*
    By checking the box below you agree that the information on this form is correct.
  7. Print Option
    For best printing results, check the box to "Receive email copy" and provide your email address.

    Look for an email with subject line of: "Online Form Submittal: Lakehaven Leak Adjustment Request Form". Ensure that your email program does not block email from "".

    Print the email from your email program.
  8. Leave This Blank:

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