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Water Saving Rebate Application

  1. Not to exceed $100 pre-tax cost per toilet (Maximum $200)

  2. Maximum file size is 20 MB.

  3. Your photo should include EPA WaterSense label and address verification, such as a piece of mail. Maximum file size is 20 MB.

  4. Use this space to upload an additional photo, if needed. Maximum file size is 20 MB.

  5. Your photo should include EPA WaterSense label and address verification, such as a piece of mail. Maximum file size is 20 MB.

  6. Use this space to upload an additional photo, if needed. Maximum file is 20 MB.

  7. Acknowlegement of Terms & Conditions*

    I have read and accept the terms and conditions of this agreement and the information contained in this application is truthful and correct to the best of my knowledge. I hereby certify that I am a Woodbury resident with a residence connected to the City of Woodbury municipal water supply and that I have installed a US EPA WaterSense approved toilet at the residence. 

    I hereby certify that I am the customer authorized to replace the components listed above, and my components have been recycled or are otherwise legally disposed of and are no longer in service.

    Agree to Terms and Conditions?

     

  8. Leave This Blank:

  9. This field is not part of the form submission.