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Reduced Utility Rate Application Form

  1. This form is used to evaluate requests for special utility service rates for low income senior citizens or disabled residents and for special non-curbside garbage pickups for customers whose physical conditions make it difficult for them to place the garbage container at the curbside location. Low Income Senior Citizens and Low Income Disabled Rates Low income senior citizens and low income handicapped residents of the City may apply to receive water and sewer services at one quarter of the monthly minimum charge.

  2. Water/Sewer Rate for Qualified Customers Water and sewer utility rates will apply to those qualified customers who utilize a 5/8-inch single family residential service. Customers requiring service in excess of a 5/8-inch single family residential service shall not qualify for a rate reduction regardless of income.

  3. (1) Low-Income: A household in which the total annual income is below the very low income level for the Seattle/Everett area as established and amended by survey from time to time by the United States Department of Housing and Urban Development. Presently, the maximum income levels are set at the amounts below: 1 -Persons Per Household, Monthly Income - $2,800, Annual Income - $33,600; 2-Persons Per Household,Monthly Income - $3,200 Annual Income - $38,400; 3-Persons Per Household, Monthly Income - $3,600, Annual Income - $43,200; 4-Persons Per Household, Monthly Income - $4,000, Annual Income - $48,000; (If more than 4 persons in the household please call 360-568-3115 for limits)

  4. (2) Senior Citizen: A person 62 years of age or older whose income provides the primary financial resources for the household in which the citizen is a full time resident.

  5. (3) Disabled: A citizen whose income provides the primary resources for the household in which the citizen is a full time resident and who has a physical impairment of such a nature as to materially affect the number and types of employment for which the individual can reasonably qualify. See Resolution 1312 for further definition.

  6. Allied Waste will provide service at non-curbside locations for qualified customers. Customers whose physical condition makes it unusually difficult or unsafe for them to bring containers to an alley or curbside location may apply for special pickup services at no extra charge. Persons requesting this special non-curbside service should fill out the attached form and provide the information requested on the form. This information will be used by the Utility Service Board to determine eligibility.

  7. Are you currently 62 years of age or older?*

  8. Are you handicapped?

  9. Will the handicap prevent you from taking your garbage to the curb?

  10. If so, is special pick up requested?

  11. Verification of income of household (Include full 2016 income tax returns with related schedules & current social security benefit statement)

  12. Documentation of disability (if appropriate)

  13. Verification of age (Copy of driver's license, birth certificate, passport, etc..)

  14. Please upload copies of your supporting documents as listed above or provide photocopies in person or via mail at Snohomish City Hall, 116 Union, Snohomish, WA 98290

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