Septic to Sewer Connection Grant Application

Septic to Sewer Connection Grant Application
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Additional Phone Number
Please enter a valid phone number.
Email (Optional – but highly recommended)
example@example.com
Have you owned your home for at least 1 year?*

YesNo
Is the property your primary residence and in your name?*

YesNo
How many people reside at your home?*
Does the total gross household income (of all the people that reside at the home) fall within the limits listed here?*

YesNo
Unfortunately, you do not meet the income requirements to qualify for the grant. However, you may still be eligible to take advantage of our 10-year interest-free financing option to help cover the cost. Please contact the Connection Support Office in City Hall at 772-873-6400 to learn more.
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