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Private Road Grant Assistance - Capital Improvements

The objective of this program is to improve access for emergency vehicles on existing private roads.

The Private Road Standard outlines the anticipated requirement for private roads.

Funding assistance is not retroactive and applies only to applications received for work completed in the year for which it is intended.

Please read the following to ensure you have the information necessary to complete this form.

Due date for the application is the first Friday in June. Late applications will not be accepted.

Name of Road Association

Name of Private Road / Lane

Please list names of all roads/lanes that are included in your membership.

Location (Closest Intersecting Roads)

Number of Seasonal Households

Number of Year Round Households

President's Name

President's Mailing Address

President's Phone Number

President's Email Address

Treasurer's Name

Treasurer's Mailing Address

Treasurer's Phone Number

Treasurer's Email Address

Secretary's Name

Secretary's Mailing Address

Secretary's Phone Number

Secretary's Email Address

If approved, who will be receiving payment on behalf of the Association?

President

Treasurer

Secretary

If approved, grant funds will be issued by Electronic Funds Transfer (EFT). Please indicate if bank account can receive EFT payments.

Yes

Name of Individual Submitting Application

Mailing Address of Individual Submitting Application

Phone Number

Applicant's Email Address

Name of Individual who is Accountable for Authorizing Work

Email Address of Individual who is Accountable for Authorizing Work