HomeMy WebLinkAbout2017 Blank Grant Program ApplicationSEBASTIAN CRA – SEPTIC-TO-SEWER GRANT PROGRAM
Approved by CRA Board – 2/8/17 Page 1
CITY OF SEBASTIAN || INDIAN RIVER LAGOON COUNCIL
The City of Sebastian and Indian River Lagoon Council seek to promote, preserve and protect
Sebastian’s waterfront heritage through Indian River Lagoon preservation efforts.
The Sebastian Septic-to-Sewer Grant Program (hereinafter referred to as SSP) is designed to
provide individual grants up to $15,000 to qualified property owners for costs incurred to remove
an existing septic tank and connect to the Indian River County sanitary sewer system. Grants
shall be awarded at the sole discretion of the CRA Board. The SSP is available to businesses or
residences located within the CRA District currently utilizing septic systems. Grant funds will be
disbursed as a reimbursement after receipts and documentation are submitted and inspection of
improvements occur. Grants from this program will not be awarded for sanitary improvements
made prior to filing a completed application.
1. The application package includes:
A. Completed application (provided by the City of Sebastian, see attached);
B. Proof of ownership of the property;
C. Proof of paid taxes and certification that owner is current on any payment
obligations to the City of Sebastian;
D. Proof of Utility Permit submittal to Indian River County with copy of plan.
2. Upon completion of the improvements, the applicant shall submit a “reimbursement package”
to the City which includes:
A. Completed Reimbursement Form (provided by the City of Sebastian, see
attached);
B. Copies of applicable invoices and receipts;
C. Proof that the septic tank has been taken out of service, pursuant to State
regulations.
D. Copies of records which indicate that the improvements have been appropriately
inspected and are in operation;
3. If the project is not commenced (with a filed Application for a Building Permit or Utility Permit)
within six (6) months of grant award or is not completed (with the final inspection) within one
(1) year of the grant award, the award shall expire. The applicant may request a six (6) month
extension.
SEBASTIAN CRA – SEPTIC-TO-SEWER GRANT PROGRAM
Approved by CRA Board – 2/8/17 Page 2
APPLICATION NO. _______
SEBASTIAN CRA SEPTIC-TO-SEWER GRANT PROGRAM
GRANT APPLICATION
1. APPLICANT INFORMATION
Name of Applicant:
Mailing Address:
Phone Number:
Cell Number:
E-mail Address:
2. PROJECT LOCATION
Address of Property:
Parcel Number(s):
Property Tax Status:
3. DESCRIPTION OF PROPOSED IMPROVEMENTS
4. ESTIMATED COST
Please provide information on the following items:
A. Cost of Current Septic System Closure $
B. Estimate of Connection to Indian River Utility System $
C. Permitting $
D. Design and Construction Costs $
TOTAL ESTIMATED PROJECT COSTS $
SEBASTIAN CRA – SEPTIC-TO-SEWER GRANT PROGRAM
Approved by CRA Board – 2/8/17 Page 3
Has the applicant applied for other regulatory grant funding to remove the targeted septic
system? (Please check appropriate answer) YES NO
If Yes, please answer the following questions:
Who was the grant award from?
How much was the total award? $
Signature(s) All owners must sign.
The information supplied in this application is true and correct.
_________________________ _________________________
Printed Name and Title Printed Name and Title
_________________________ _________________________
Signature Signature
STATE OF ___________________
COUNTY OF _________________
The foregoing instrument was acknowledged before me this ______ day of ________________,
20__, by _____________________________________________________________________,
who is/are personally known to me or has/have produced _________________________ as
identification.
(SEAL)
_____________________________ Notary Public, Commission No. _____________________
______________________________ (Name of Notary, Printed or Typed)
This Section for City Use Only
Date Application Received:
Date Application Reviewed:
Recommendation to CRA:
Action by CRA:
SEBASTIAN CRA – SEPTIC-TO-SEWER GRANT PROGRAM
Approved by CRA Board – 2/8/17 Page 4
APPLICATION NO. _______
SEBASTIAN CRA SEPTIC-TO-SEWER GRANT PROGRAM
GRANT REIMBURSEMENT REQUEST FORM
1. APPLICANT INFORMATION
Name of Applicant: _________________
Address of property awarded grant:
_____________
_____________
Phone Number: _______
Cell Number: _____________
E-mail Address: _______
2. GRANT REIMBURSEMENT AMOUNT (SUBMIT PAID RECEIPTS FOR EACH ITEM LISTED.)
A. Septic System Closure Costs $
B. Connection to Indian River Utility System Costs $
C. Permitting Costs $
D. Design and Construction Costs $
TOTAL AMOUNT OF EXPENDITURE $
This Section for City Use Only
Date Grant Awarded by CRA:
Date Building Permit Issued:
Date Improvements Passed Inspection:
Amount Awarded:
Amount to be Reimbursed:
Date of Payment: