86 Main Road, Tiverton, RI Phone Fax

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1 86 Main Road, Tiverton, RI Phone Fax RESIDENTIAL SEWER CONNECTION APPLICATION PROCEDURE The following procedure shall be followed for all residential sewer connection applications: 1. Obtain a Residential Sewer Connection Application Packet on-line at or at the Tiverton Wastewater District (TWWD) Office at the above address. The application packet includes these instructions and the following: a. Sewer Tie-In Flow Chart b. TWWD Sewer Betterment Assessment Agreement c. TWWD Sewer Connection Application 2. Complete the Sewer Betterment Assessment Agreement and submit to TWWD along with $2,700 check made payable to Tiverton Wastewater District. If full payment of the assessment will not be made at the time of application, TWWD provides options for quarterly payments over 1 and 3 year terms. See assessment agreement form for additional information. 3. Complete the sewer connection application. When completing the application, you will also need to do the following: a. Confirm with Tiverton Department of Public Works that the contractor for your connection project has a current street excavator s license issued by the Town and that their insurance and bond certificates are current. Contractors can obtain a street excavators license through the Town of Tiverton (DPW Phone (401) ). Also, any excavation work within Fall River streets must be performed by contractor licensed to do so by the City. b. For new building construction, provide three (3) copies of your building floor plan. c. For new and existing building construction, provide three (3) copies of your exterior site plan and profile showing proposed sewer service connection. d. For new building construction, provide a check for the sewer application fee as calculated by the TWWD. Check shall be made payable to the City of Fall River. 4. If your installation requires any excavation within the street, your contractor will be required to obtain a Street Opening Permit from the Tiverton DPW. Forms and information can be found on If your installation includes excavation in Fall River, you will be required to obtain a Fall River Street Opening Permit. If your installation includes excavation within a State right of way, you will be required to obtain a Physical Alteration Permit from the Rhode Island Department of Transportation. PAP information can be found on 1 Revised 4/2015

2 5. Once your Sewer Connection Application is approved by TWWD and a copy of the fully executed road opening permit from Town of Tiverton has been filed with TWWD, the District will issue to you in writing a Notice-To-Proceed with the installation of your sewer connection. 6. You must contact the TWWD a minimum of forty-eight (48) hours prior to installation of your sewer service to schedule an inspection. Your contractor will not be allowed to backfill the pipe until it is inspected, a sketch of the installation is completed, and photographs of the installation are taken. Inspections can be scheduled for Monday through Friday 9:00 am to 4:00 pm. 7. Your contractor will be required to forward an As-Built submittal of your sewer connection to the TWWD after he/she has completed the sewer connection work. The As-Built submittal must include the following information: a. The sketch of the installation, including ties to the connection point as well as all bends in the pipe. Depth to pipe at the connection point, at the foundation wall as well as at 75-foot intervals shall also be included on the sketch. b. He/she must also include enough photographs to properly document all segments of the installation. 8. Once the TWWD receives your As-Built submittal, we will issue you a Residential Wastewater Discharge Permit and TWWD account number. TWWD will submit a copy of the Permit to the Town of Tiverton Building Inspector and Tax Assessor offices as well as the appropriate water authority. NOTE: You will not get your Certificate of Occupancy (CO) until after the Permit is submitted to the Building Inspector s office. CHECK LIST Betterment Assessment Agreement and Sewer Connection Application: a. ( ) TWWD Sewer Betterment Assessment Agreement b. ( ) Betterment Assessment Check made payable to Tiverton Wastewater District c. ( ) TWWD Sewer Connection Application d. ( ) 3 copies of your building floor plan (new construction only) e. ( ) 3 copies of your engineer s plan & profile f. ( ) Application Fee Check made payable to City of Fall River (new construction only) Sewer Connection Installation: g. ( ) Application approved by TWWD h. ( ) Obtain all necessary street opening permits i. ( ) TWWD written Notice-To-Proceed received by homeowner j. ( ) Call for inspection at least 48 hours prior to installation k. ( ) Document the installation with AS-BUILT sketch and photographs l. ( ) Submit AS-BUILT package to TWWD m. ( ) Receive Wastewater Discharge Permit 2 Revised 4/2015

3 SEWER TIE-IN NOTIFICATION SIGN BETTERMENT AND APPLY FOR SEWER PERMIT I know how much it will cost me to tie into the sewer NO OBTAIN QUOTE FROM CONTRACTOR HAVE FUNDS FOR TIE-IN NO APPLY FOR STILF LOAN NOT APPROVED SEWER TIE-IN FLOW CHART APPLY TO CHURCH COMMUNITY HOUSING NOT APPROVED REQUEST FINANCIAL HARDSHIP EXTENSION APPROVED APPROVED PAY FOR BETTERMENT AND SEWER CONNECTION TIE-IN FEE (TBD BY SUPT) SEWER TIE-IN COMPLETED AUTHORIZE CONTRACTOR TO BEGIN

4 TIVERTON WASTEWATER DISTRICT 86 MAIN ROAD TIVERTON, RI PHONE: (401) FAX: (401) SEWER BETTERMENT ASSESSMENT AGREEMENT 1. Name and Address of Property Owner: Owner's Name: Connection Address: Mailing Address: 2. Telephone Number: PROPERTY INFORMATION 3. Type of Property ( ) RESIDENTIAL ( ) INDUSTRIAL ( ) COMMERCIAL 4. For Multi-Unit Residential: Number of Units: Total Number of bedrooms: 5. For Commercial or Industrial: TYPE OF ESTABLISHMENT: 6. BETTERMENT FEE : SQUARE FOOTAGE OF BLDG. # SEATS IF RESTAURANT 7. BETTERMENT PAYMENT SELECTION: ( ) FULL PAYMENT AT TIME OF APPLICATION ( ) FUNDS FROM THE SEWER TIE-IN FOR SINGLE FAMILY RESIDENTIAL: LOAN FUND (STILF) WILL BE USED ( ) FOUR QUARTERLY PAYMENTS OF $ OVER TO PAY BETTERMENT FEE ONE YEAR (Total $2,700.00) ( ) TWELVE QUARTERLY PAYMENTS OF $ OVER THREE YEARS (Total $2,880.00). EACH PAYMENT SHALL CONSIST OF $225 PRINCIPLE PAYMENT PLUS $15 PAYMENT SURCHARGE. This Sewer Betterment Assessment (Assessment) shall constitute a lien upon the real property that is served and benifitted by the connection to the sewer main Please be aware that you are liable for the full and complete sum of the Assessment. By signing below you acknowledge that you have read and understand the terms of this Assessment and promise to pay said Assessment in accordance with the terms of your selection in Section 7 above. Failure to pay the Assessment according to the terms thereof, may result in the addition of penalties and interest. The real property subject to the assessment may be sold by the Tiverton Wastewater District due to unpaid and delinquent Assessment payment or payments. Failure to sign below does not relieve you from the Assessment. If you do not sign this form, you will automatically be assigned the three-year payment schedule. Late payments are subject to a 1% monthly penalty on total outstanding balance. APPLICANT'S SIGNATURE: (PLEASE PRINT YOUR NAME): AMOUNT: CHECK NUMBER: APPROVED BY: Superintendent: 4/2015

5 TIVERTON WASTEWATER DISTRICT 86 MAIN ROAD TIVERTON, RI PHONE: (401) FAX: (401) SEWER CONNECTION APPLICATION PROPERTY ADDRESS ASSESSORS PARCEL ID OWNER'S INFORMATION ( ) FUNDS FROM SEWER TIE-IN LOAN FUND NAME MAILING ADDRESS WILL BE USED TO PAY THE SEWER PHONE NUMBER CITY STATE ZIP APPLICATION FEE. PROJECT INFORMATION PROJECT TYPE ( ) RESIDENTIAL ( ) COMMERCIAL ( ) INDUSTRIAL ( ) NEW CONSTRUCTION WATER SOURCE ( ) CITY WATER ( ) WELL WATER SUPPLIER: ACCOUNT # PROPOSED CONTRACTOR (to be completed before issuance of connection permit) CONTACT: COMPANY NAME: PHONE: ADDRESS: NOTES: RI DIG SAFE (800) Call TWWD to schedule an inspection of service installation at least 48 hours in advance of the start date. TWWD (401) DPW Director's written approval of any road patch TIVERTON DPW (401) & and AS-BUILT drawing must be submitted to and approved by TWWD before Sewer Discharge Permit will be issued. I (We) hereby agree to be bound by the provisions of the 18 Sewers and Sewage Disposal Ordinance of the Tiverton Code and to such special conditions, restrictions, and regulations as may be imposed by the Tiverton Wastewater District, the Town of Tiverton, and the applicable State and Federal agencies. SIGNATURE OF OWNER SIGNATURE OF APPLICANT FOR OFFICIAL USE ONLY ASSESSORS Application Checklist: MAP BLOCK CARD Application Form Complete Residential - New Construction Application Fee Check to FR Number of bedrooms per Tax Card Assessor Property Card Estimated Flow gpd Assessor Plat Map ( # of bedrooms x 110 gallons per day) Building Floor Plan Commercial/Industrial Site Plan and Profile Type of establishment Betterment Agreement Usage Type* per Unit # of Units Total Flow Betterment Check to TWWD 1.) x = GPD STREET OPENING PERMITS INITIALS 2.) x = GPD TIVERTON DPW ( ) Y ( ) N 3.) x = GPD FALL RIVER DPW: ( ) Y ( ) N 4.) x = GPD (*MA Title 5 use tables) SEWER APPLICATION FEE : (Estimated Flow GPD X $5.00 ) = $ SEWER CONNECTION APPROVED DISAPPROVED SUPERINTENDENT'S SIGNATURE FALL RIVER SEWER COMMISSION FALL RIVER DPW ENGINEERING rev 3/2015

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