Only fill out this form if you meet the following requirements:
- You are the applicant, and you own the property (it may be tenant‑occupied)
- The property is residential, or if mixed-use, it is primarily residential
- The property does not contain more than four units
- The property received a Notice of Defect for a repair required on the property’s water service pipe or sewer lateral, and/or related components
A Notice of Defect is NOT required if you are applying to replace a lead service line
- The payment agreements (if applicable) for the property are current
- The property is served by an operable water meter
- Applicant is not delinquent on their monthly water bill(s) for more than 2 cycles, for the property with the Notice of Defect and other properties owned by the applicant
- You consent to the placement of a lien on the property for the amount of the total cost of the work
For Lead Service Line replacement only:
Having an issue with the form?
Call 215-685-4901 to apply via phone.