Lead Service Line Replacement Reimbursement

To be completed by the property owner. Please fill out the form below. You will receive an email confirmation if your application is approved.
How many service lines are being replaced?*

OneMore than one
Property Owner Information
Property Owner Name*

First NameMiddle NameLast Name
Please include proof of property ownership. We will accept any of the following: copy of deed, deed of trust, mortgage statement, property tax certificate/statement, or a homeowner’s insurance statement.*

Cancelof
Property Owner Contact Information
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*

Confirmation Emailexample@example.com
Property Owner's Address (where replacement will occur)

Property must have an active account and receive a bill from Denver Water for water service. If you don’t have an active account, you can contact Sales Administration to discuss your options at 303-628-6100 or emailing watersales@denverwater.org.
Address*

Street Address

Street Address Line 2 (e.g., unit, apartment or suite number)

City

ZIP Code
Property Owner's Addresses (where replacement will occur)

You can add additional addresses below. Property must have an active account and receive a bill from Denver Water for water service. If you don’t have an active account, you can contact Sales Administration to discuss your options at 303-628-6100 or emailing watersales@denverwater.org.
More than one property address*
Is the mailing/billing address different?

Yes
Mailing/billing address*

Street Address

Street Address Line 2 (e.g., unit, apartment or suite number)

CityState

ZIP Code
Contractor Information

See list of qualified contractors.
Company*
Email
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2 (e.g., unit, apartment or suite number)

CityState

ZIP Code
Denver Water will send a reimbursement check to the property owner through the mail. Please consult with a tax professional to determine whether this reimbursement is taxable.

Also, Denver Water is collecting information on the service lines being replaced and customer information in order to improve this reimbursement program.
Please indicate if the work on the service line involves a full replacement of the line (from inside the home to the connection to Denver Water’s delivery main in the street), or if it is a partial replacement (only a section of the full line).*

Full replacementPartial replacementUnknown
Note: A reimbursement for a partial replacement is only accepted IF there is no lead remaining at any point in the service line and the untouched portion of the service line is made of copper.
If the work being done is a partial replacement, please confirm which section is being replaced.*

Main to meterMeter to property
Will the lead service line replacement work occur in conjunction with other construction projects at the property or demolition of a structure?*

YesNo
If yes, please review Denver Water’s Scrape-Off Policy.
To help improve the program, please indicate your household income. (This information is optional and will not be a factor in reviewing the application for reimbursement.)

Less than $50,000/yearMore than $50,0000/year and less than $75,000/yearMore than $75,000/year and less than $100,000/yearMore than $100,000/year and less than $150,000/yearMore than $150,000/year and less than $200,000/yearMore than $200,000/year and less than $250,000/yearMore than $250,000/year and less than $300,000/yearMore than $300,000/year
Please indicate your estimated value of your property.

Between $200,000-$400,000Between $400,000-$600,000Between $600,000-$800,000Between $800,000-$1,000,000Between $1,000,000-$1,500,000Between $1,500,000-$2,000,000More than $2,000,000
You will receive an email regarding the status of your application.

After Denver Water has approved your application for reimbursement, you may begin work to replace your service line. If Denver Water does not approve your application, you are free to replace your service line, but you will not be eligible for reimbursement.

For additional questions regarding the reimbursement process, contact Denver Water Sales Administration by calling 303-628-6100 or emailing WaterSales@denverwater.org.
Please verify that you are human*
Should be Empty:

Property Owner Information

Property Owner Contact Information

Property Owner's Address (where replacement will occur)

Property Owner's Addresses (where replacement will occur)

Contractor Information