Water Service/Sewer Lateral Replacement Grant Application Form

The City of Port Colborne offers Water Service and Sewer Lateral Replacement Grants to assist homeowners with costs of replacing their water and/or sewer lines.

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:

Name of property owner submitting this application (contact person)

Phone Number

What is this application for? Please select all that apply:

Grant: Water Service $2,000

Grant: Sewer Lateral $2,000

Grant: Both water and sewer $5,000

Total grant amount being requested:

Job estimate(s) submitted are to replace:

Water Service

Lateral (Sewer) Service

Both

What is the total estimated cost for the replacement of service(s):

Please outline any other costs (provide additional details below as necessary):

Please attach copies of all estimates you have received to support the 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, as required by the Grant Terms and Conditions.

Applicant's signature

Sign above