Application for Permit to Tap Sewer Line

This application for a permit to tap the sewer line is completed by the property owner. It includes the street address and legal description, the agent (if applicable), and contractor/excavator contact information. Upon approval and payment of the tap fee and inspection fee, a permit will be issued to tap the District’s service line for sanitary sewer service.

  THE UNDERSIGNED owner of the following described property hereby applies for a permit to tap the sewer line of the Buena Vista Sanitation District for the purposes shown below and, in connection therewith, agrees to be bound by and to comply with the rules, regulations and engineering standards of the District.  The sewer tap, related hardware and service line extending from the property must be maintained at the owner’s expense.  The owner is liable for all damages caused by any leaks from said sewer tap, related hardware and service lines and indemnifies the District against any loss (including reasonable attorney’s fees) caused by the owner’s failure to satisfy such liability.

            THE UNDERSIGNED agrees that the excavation will be left open until inspected and approved by the District and that Owner’s contractor or excavator is named below.  The undersigned must give the District forty-eight (48) hours advance notice for final inspection.  The undersigned also acknowledges that a check valve is required in all basement drains.

            THE UNDERSIGNED agrees that monthly billing commences on the date the tap connection is made.

Street Address 1 (required)

Street Address 2

City (required)

State (required)

Zip Code (required)

Legal Description (required)

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Owner's Signature

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

Date (required)

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Owner's Information

Mailing Address 1 (required)

Mailing Address 2

City (required)

State (required)

Zip Code (required)

Phone (required)

Email

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Agent's Signature (If Applicable)

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

Date

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Contractor/Excavator Information

Name (required)

Phone

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Tap Description

Explain what you are building and the use of the property (Examples: Single Family (SFR), SFR w/Apartment, Basement, Commercial) (required)

Acknowledgement (required)

**NOTE: IN THE EVENT OF ANY CHANGES MADE TO THE PHYSICAL BUILDING OR ANY CHANGE OF THE USE FOR THE PROPERTY, PLEASE NOTIFY THE DISTRICT FOR POSSIBLE CHANGE OF EQR & ADDITIONAL APPLICABLE FEES (eg: add apartment, going to commercial use).

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