Water Line Replacement Grant Program Application

Required fields are marked with asterisks (*)

Request to participate in the grant program

To participate in the Water Service Replacement Grant Program, please complete and submit the following form. Once your request to participate is received, Water Services will contact you to schedule a free grant program pre-inspection to determine the depth and location of the water service and to assess grant eligibility and maximum potential grant amount.

Be sure to review the full Water Line Replacement Grant Program Terms and Conditions to ensure you agree and qualify for a grant.

Contact information

Property owner name

Add Property Owner Remove Property Owner

Phone Number

Address

Street number

City

Province

Postal code

Is the listed address also your mailing address?

yes

Application Information

Are there children under the age of 6, pregnancies or planned pregnancies in the home?

yes

Have you had your home tested for lead by Water Services?

yes

I have read, understood and agree to the terms and conditions of the Water Line Replacement Grant Program.

yes

Personal information, as defined by the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) is collected under the authority of the Municipal Act, 2001, and in accordance with the provisions of MFIPPA. Personal information on this form will be used for the purpose of processing Water Line Replacement Grant Program.

If you have any questions regarding the above program please contact Water Services at 519-822-1260 extension 2633 or conservation.rebateprograms@guelph.ca.

If you have questions about this collection; use, and disclosure of this information, contact the City of Guelph’s Access, Privacy and Records Specialist at 519-822-1260 extension 2349 or privacy@guelph.ca