Introduction
Please note that this application form is for domestic claims only. If you are claiming as a business please email for an appropriate form.
The maximum grant that can be applied for is £5,000 (including VAT costs). Any costs incurred above £5,000 will need to be met from your own funds.
Before completing this form please ensure you read through the associated guidance notes.
It should take you about 30 mins to fill in this form
If you are not sure about anything in this form, you can contact us on01225 39 4443 or email / Contents
  1. Applicant information
  2. Date of flooding
  3. Property flooded information
  4. Cause of flooding
  5. Description of damage caused
  6. Current or retrospective application
  7. Resilience measures that you plan to install
  8. Quotations
  9. Retrospective application details
  10. Alternative funding sources
  11. When you expect to make a claim
  12. Bank details
  13. Checklist
  14. Data Protection
  15. Declaration
  16. Next steps

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  1. Applicant information – this must be the person responsible for the fabric of the flooded property - tenants will need to obtain written permission from their landlord in order to make any structural changes to the property.

Title (Mr/Mrs/Ms etc)
Name of applicant
Address
Postcode
Telephone Number
Mobile
e-mail
  1. Date of flooding

Date property was initially flooded / (DD/ MM/ YYYY)
Date flooding ended / (DD/ MM/ YYYY)
  1. Property flooded

Address of property that was flooded (if different from above), including postcode
Address
Postcode
  1. Do you know the cause of the flooding?

River flooding

Highway drainage

Runoff from hills/ surrounding land

Other – please specify in the box below

  1. Please briefly describe the primary damage that was caused

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Please supplyany photos showing the flooding itself or the damage caused by flooding.
You will need toprovide a copy of correspondence with your insurer confirming that property level flooding took place at your property.
  1. Is your grant application for

Resilience/ resistance measures that you will install in the future should your grant be approved? / Yes/ No
For resilience/ resistance measures that you have already purchased and installed following the flooding (retrospective application)? / Yes/ No
  1. Resilience measures you are planning to install
Please indicate which of the available resilience/ resistance measures you intend to install or have already installed (if a retrospective application), and cost (including VAT).
Three like for like quotes should be provided with your application to support the identified cost. Alternatively, retrospective applications should answer question 9.
Please note - the maximum grant that can be applied for is £5,000 (including VAT costs). Any costs incurred above £5,000 will need to be met from your own funds. The final value of the approved Grant will be at the discretion of Bath & North East Somerset Council.
When selecting which measures you intend to install, please read the application guidance notes and we strongly advise that you consider information available on reference websites such as The guidance will help you select the appropriate resilience/ resistance measures for the nature of flooding in your area – not all of the identified measures may be appropriate, and may make limited difference to protecting or minimising the damage to your premises. Should you choose to seek professional advice prior to making an application, you can retrospectively claim up to £500 of the cost as part of your application.
Resistance Measures / Cost £s / Resilience Measures / Cost £s
Demountable Door Guards / Replace sand-cement screeds on solid concrete slabs (with dense screed)
Demountable Window Guards / Replace chipboard flooring with treated timber floorboards
Airbrick Cover / Replace floor including joists with treated timber to make water resilient
Sewage Bung / Replace timber floor with solid concrete
Toilet Pan Seal / Raise floor above most likely flood level
Sump Pump / Replace mineral insulation within walls with closed cell insulation
Re-pointing external walls with water resistant mortar / Replace gypsum plaster with water resistant material, such as lime
Waterproof external walls / Install chemical damp-proof course below joist level
Automatic Door Guards / Replace doors, windows, frames with water-resistant alternatives
Permanent flood door / Sceptic tank resistance or resilience measures (such as isolation valves, venting above flood level etc)
Automatic Window Guards / Mount boilers on wall
Self-closing airbrick / Move washing machine to first floor
Non-return valves 110 mm soil waste pipe / Replace ovens with raised, build-under type
NRV 40 mm utility waste pipe / Move electrics well above likely flood level
NRV 12 mm overflow pipe / Move service meters well above likely flood level
Garage/ Driveway Barrier / Replace chipboard kitchen/ bathroom units with plastic units
Professional advice on flood resistance/ resilience / Flood Risk Report
Total Cost of Resilience/ Resistance Measures implementing / £
Total Amount of Grant Applying for if different (maximum £5,000 including VAT) / £
  1. Details of quotations obtained for PROPOSED WORK
Three like for like quotes for the purchase and installation of the identified measures should be included with your application. If you have not selected the cheapest available quote, please briefly explain why.
  1. RETROSPECTIVEapplications only – If you are applying for works that have already been undertaken, please briefly describe how you ensured value for money i.e. utilised insurance company contractor, or sought quotes from a range of providers. Please ensure you include evidence of quotes and invoices along with your application.

  1. Alternative funding sources
Have you received any alternative funding (such as previous grant funding or insurance claim payment) for any of the resilience measures you are applying to the grant fund for? / Yes/ No
If yes, please specify and state why you are also seeking Repair and Renew Grant support.
  1. When you expect to make a claim
Should your application be approved, please indicate the month you expect to make a grant claim. You are reminded that grant claims can only be made once the installation has been fully completed and contractors paid from your own funds.
  1. Details of the financial account into which the grant should be paid
Please complete your bank/building society details below. Please note that grants will only be paid into your account subsequent to resilience and/or resistance measures having been installed, invoiced and paid for and evidence of such provided. Refer to the guidance notes for details.
PAYEE NAME:
PAYEE ADDRESS:
TELEPHONE No. / MOB No.
E-MAIL ADDRESS:
YOUR BANK/BUILDING SOCIETY NAME:
YOUR BANK/BUILDING SOCIETY ADDRESS:
ACCOUNT NUMBER: / SORT CODE:
ROLL NUMBER (if applicable):
NAME: (print) / SIGNATURE:
  1. Checklist

Your application should include:

A completed and signed application form

Copies of three quotes for planned resilience measures for proposed works

Any supporting photographs or other evidence of flooding

Copies/evidence of quotes and invoices for all retrospective applications

Any correspondence with your insurer regarding the property flooding

  1. Data Protection

The information which you have provided will be used to enable Bath & North East Somerset Council to assess and administer your claim for the Repair and Renew Grant. The information will be secure, not used for any other purpose and will be kept no longer than necessary.

  1. Declaration

To the best of my knowledge, the information in this form and all other information given in support of this application are correct.

I confirm that I understand the purpose of this form and the reasons for the collection of my personal data and that I agree to my personal data being used as stated.

I agree to inform Bath & North East Somerset Council immediately of any change of circumstance or information that may affect this application.

In applying for this Domestic Repair and Renew Grant I agree that Bath & North East Somerset Council may inspect my property to assess evidence of flood damage, and the installation of resilience and/ or resistance measures.

Warning – if you knowingly or recklessly make a false statement to obtain grant for yourself, or for/on behalf of anyone else, you risk prosecution and the recovery of all grant payments. Your signature on this formindicates that you have read, understood and agree with the above declaration.

Name: ………………………………………………………………………….

Signed: …………………………………….……………………………………

Date: ……………………………………..

  1. Next steps

Please return this form together withall supporting documents to:

Repair and Renew Domestic claims

Highway Maintenance and Drainage

Bath North East Somerset Council

Floor 2, Riverside

Temple Street

Keynsham

Bristol BS31 1LA

Alternatively you can email your application (and all supporting documents) to:

If you need help completing this or phone 01225 39 4443.

Please tell us if you have any communication needs such as requiring information in a different language or alternative format (for example, in large print, in Braille or on CD).

What happens next?

Once we have received your form we will send you acknowledgment of receipt.

We will then consider your application for up to 28 days and will write to you with a decision of approval or rejection.

If your claim is approved we will send you a pack including a Grant Claim Form and Contract (a specimen copy of which is included in this application pack for your reference).

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