Eligibility Requirements:
• Products must be purchased
after
• Rebate maximums are:
$50 for Water Sense Toilets
$200 for Energy Star Washers
$150 for Water Sense Irrigation Controllers
$10 per WaterSense® sprinkler head replacement up to $150
• Rebates cannot exceed
50% of the PRE-TAX purchase price
of
each product.
• Each new item must be a
or
labeled
product. Documentation of certification must be provided with
application.
Other Rebate Information:
• The City reserves the right to inspect for proper installation.
• Irrigation controllers
be programmed to follow the
City’s Odd/Even Water Use Restrictions.
• The City has the right to discontinue or amend the rebate
program at any time.
Completed Application Form
A copy of the itemized invoice or receipt documenting
the purchase date, make and model of the item.
Documentation of
or
Certification
Send Completed Application to:
Email: WaterRebates@FarmingtonMN.gov
Or mail to: Farmington Water Rebate
430 Third Street
Farmington, MN 55024
Rebate will be credited to the applicant’s water utility
account when the application is reviewed and approved
.
Purchase Price (pre-tax):
Product Purchase Date:
Must be after Jan.1, 2020
Customer Agreement:
My s
ignature indicates that the information provided is true, I
have read and understood the rebate program guidelines, and
that I comply with the City of Farmington rebate program
requirements. Upon compliance, a rebate will be distributed if
funding is available at the time of application. I will allow a
representative of the City of Farmington to verify the
installation if requested.
Signature:
Product Information:
Washer Irrigation Controller
Toilet Sprinkler Head(s) Qty:_____
Where Purchased:
Name of Installer:
Make and Model of Product(s):
Installation Date:
Applicant Information:
Rebates available to Farmington utility customers with non-
delinquent accounts. Rebates will be issued as a CREDIT
on the applicant’s utility billing account.
Applicant Name:
Utility Billing Account #:
Utility Billing Customer #:
Installation Information Applicant Information
2020-2022 Water Efficiency
Rebate Program
Application Form
OFFICE USE ONLY Date Received:_______________
Attached Receipt WaterSense/Energy Star Cert. Device
Total Allowable Rebate:__________________________________
Approved by:____________________ Date:__________________
Installation Address:
Eligible devices must be installed in a residence supplied
with water from the City of Farmington.
Address:
City:
State: Zip:
Contact Information:
Primary phone:
Email:
