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Please complete the following form for all sewer

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Please complete the following form for all sewer and water billing adjustment requests. Make sure to
include all needed documentation. Plumbing invoices are required for all requested leak adjustments.
After your application is received, please allow up to 2 weeks for a decision.
Applications can be submitted in the following ways:
In Person: 6670 Lockville Road, Carroll, Ohio 43112
Fax: (614) 322-5203 or (740) 652-7129
Email: amanda.mccrady@fairfieldcoutyohio.gov or
akela.george@fairfieldcountyohio.gov
CONTACT INFORMATION
First Name
Last Name
Date
Account Number
Address
City
State
ZIP Code
Phone
E-mail
Issue for Review
Please explain the issue for review:
FOR OFFICE USE ONLY
Determinations:
Signature:
Date:
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Please complete the following form for all sewer

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Completed 17 July 2020

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