Sewer Disconnect and Backflow Grant Application Form

As part of the 2025 Water and Wastewater budget, City Council approved a grant program to assist residents with the cost of installing a backflow prevention device or disconnect from the storm sewer.

Please read the Grant Eligibility and Conditions before completing the application.

Property Address

Property owner name(s). Please list ALL owners.

Water/Wastewater Account Number

Your Water/Wastewater account number is located on the top left of your Water/Wastewater Bill. See below example:

Water and wastewater bill from the City of Port Colborne, featuring contact details and dates.

Name of property owner submitting this application (contact person).

Phone Number

If you have experienced a sewage backup on this property, in what year was the last backup?

Which grant(s) are you applying for? Please select all that apply.

Grant: Backflow Prevention Device, $1000.00

Grant: Sewer Disconnect, $2500.00

Total grant amount being requested:

Job estimate(s) submitted are to:

Install a backflow prevention device

Disconnect a stormwater flow from the wastewater system

Please outline any other costs (supply additional details below as necessary).

Please attach copies of all estimates (quotes) you have received to support this application.

Unlimited number of files can be uploaded to this field.
32 MB limit.
Allowed types: txt rtf odf pdf doc docx ppt pptx xls xlsx.

Agreements. Please select all.

I hereby certify that I am the owner of the property and will have the work completed as described above.

I hereby certify that I have read, understand, and agree to the Grant Terms and Conditions.

I hereby certify that I have applied or will apply for a building permit, if required by the Grant Terms and Conditions.

Applicant's Signature

Sign above