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Septic to Sewer Conversion Program
Please complete this form to apply for the
Septic to Sewer Conversion Program
.
Conversion Type
Choose one
My property is served by municipal water
My property is served by a well
First Name
Last Name
Address
Address 2
(Optional)
City
State
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Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Is
Northwest Territories
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Postal Code
Phone
Email
Confirm Email
I have proper authority to submit this application. I understand and agree that: (1) this is an application only, and I am not guaranteed funding upon submission or approval to participate; (2) this is a reimbursement program that covers only 85% of eligible conversion costs for approved participants up to a maximum reimbursement of $40,000, when funding is available and all program requirements have been met; and (3) if approved to participate, I will abandon my septic system and connect to a public sewer, and the SNWA will not be responsible or liable for and provides no guarantees or warranty of any kind with respect to any project design, engineering or construction.