St. Lucie West
S E R V I C E S	D I S T R I C T

WATER CONSERVATION REBATE PROGRAM APPLICATION

PROGRAM TERMS AND CONDITIONS:
Program funding is limited. Applications will be processed on a first-come first-serve basis while funding is available.
The fixtures must be installed at a location served by the St. Lucie West Services District Water Department.
The rebate application must be received by the district within ninety (90) days of purchase date.
A representative of SLWSD Water Department must be permitted to inspect the property to verify installation.
New construction projects and remodeling projects requiring a building permit do not qualify for rebates.
Rebates are available for the following: Replacing a max of two (2) toilets that use 1.6 gallons per flush or less and a max of two (2) Shower heads that use 1.5 gallons per minute or less.
Rebates are limited to two toilets and two shower heads per household or business for the lifetime of the property.
Refer to Chapter III Section 38 for the complete rules and regulations of the Water Conservation Rebate Program.
INSTRUCTIONS:
Purchase and install a qualiﬁed water-saving device.
Complete this form and attach the original sales receipt, or itemized plumber’s invoice showing the date of purchase. Return to the St.
Lucie West Services District Water Department for processing.
An on-site inspection by a representative on SLWSD Water Department will be scheduled to verify installation before rebate is approved.
Allow four to six weeks from the date the application was received to obtain a rebate

Applicant Information

Name:

Property Address:

Mailing Address (if diferent):

Phone Number:	SLWSD Utility Account Number:

Purchase Veriﬁcation (check all that apply)

  Low Consumption Toilet (1.6 gallons per ﬂush or less) – $100 Rebate (Max Limit 2)
Purchase Price $	_ Date Purchased:	Number of Toilets Replaced:	Date of Installation:
 Low Consumption Shower Head (1.5 gallons per minute or less) – $10 (Max Limit 2)
Purchase Price $	Date Purchased:	Number of Shower Heads Replaced:	Date of Installation:

Signatures

I have read, understand, and agree to the terms and conditions as stated in this application. If the applicant is not the owner, the owner’s signature must accompany the applicant’s signature for legal purposes.
Applicants Signature:	Date:

Owner Signature:	Date:

Oficial Use Only	
Ofice Review: ☐ Approved ☐ Denied	Comments:	
Inspection: ☐ Pass ☐ Fail	Completed By:	Date:	
Application Status: ☐ Approved ☐ Denied	Amount $	Completed By:	Date:	
Processing Completed By:	Date:	To SDS:	
Application No.: FY26 -	
450 SW Utility Drive, Port Saint Lucie, FL 34986 Tel: 772-340-2440 Fax: 772-871-5771 www.slwsd.org