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.Format: (000) 000-0000.
Additional Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email (Optional – but highly recommended)
example@example.com
Have you owned your home for at least 1 year?
Is the property your primary residence and in your name?
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?
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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