Lateral Maintenance Policy and Reimbursement Request Form

To submit a request electronically, please fill out the following form completely, upload supplementary documentation, and then click "Submit."

Customer/Resident Mailing Address(Required)
Address of Property Where Work Was Completed (if different from above)
Accepted file types: jpg, pdf, png, gif, Max. file size: 50 MB.
Accepted file types: jpg, pdf, png, gif, Max. file size: 50 MB.
Accepted file types: jpg, pdf, png, gif, Max. file size: 50 MB.
Release and Disclaimer(Required)
By acknowledging/checking above, the applicant, in consideration of any reimbursement, does hereby voluntarily discharge and release Metropolitan Sewer Subdistrict d/b/a MetroConnects (“MetroConnects”) and its officers, employees, agents from any and all claims, actions, causes of action, losses, demands, rights, damages, costs, loss of service, expenses and compensation whatsoever, which the undersigned now has/have or which may hereafter accrue on account of or in any way growing out of any and all known and unknown, foreseen and unforeseen property damages and any consequences resulting therefrom or to result from the occurrence referenced in this Reimbursement Form (the “Incident”). It is understood and agreed that this settlement is the compromise of a disputed claim, and that any payment made is not to be construed as an admission of liability or guilt on the part of MetroConnects. MetroConnects specifically denies any liability arising from the Incident. The undersigned further declare(s) and represent(s) that no promise, inducement or agreement not specifically expressed herein has been made to the undersigned, and that this Release contains the entire agreement between the parties hereto, and that the terms of this Release are contractual and binding upon the undersigned and its heir and assigns. The release shall be governed by South Carolina law. THE UNDERSIGNED HAS READ THE FOREGOING RELEASE AND FULLY UNDERSTANDS ALL TERMS SET FORTH HEREIN.