Application for Water and Sewage Connection

SCHEDULE “A” APPLICATION TO CONVERT TO CITY OF MIRAMICHI WATER AND SEWAGE SYSTEM
Uncover, make any connections to, use, alter or disturb the water and/or sewerage system under the jurisdiction of the City of Miramichi.
Iyour name of cityapply to connect to the water and/or sewerage system administered by and under the jurisdiction of the City of Miramichi.
Location of Lot (Street Name):
Type of Building:
Proposed Date of Hook-up:
WE AGREE AS FOLLOWS:
1)We represent/we are the legal owners of the property.

2)We hereby grant to the agents as assigned by the City of Miramichi, the right to enter the property for the purpose of inspecting the installation of the water and/or sewerage service a nd further grant the right to enter the property for the purpose of meter reading.

3)We agree to abide by and be subject to all the terms and conditions set forth in the City of Miramichi By-Law Respecting Water and Sewerage Systems (By-Law #52) and, in particular, we agree to pay the City of Miramichi the water and/or sewerage rates or charges that may be set from time to time pursuant to the By-Law Respecting Water and Sewerage Systems.

4) We agree to provide the City with a copy of the Department of Labour’s plumbing permit prior to the installation of the service.

5)We agree that with approval of this application by the City of Miramichi, we become
responsible for all direct or indirect costs which may result from any work performed under the issued permit, and furthermore, if the installation procedures do not meet the approval for the City of Miramichi, the issue permit may be revoked without notice.
CITY OF MIRAMICHI APPLICATION FEES ARE AS FOLLOWS:
WATER OR SEWERAGE SERVICE - $1500.00 (FIFTEEN HUNDRED DOLLARS)

WATER AND SEWERAGE SERVICES - $3000.00 (THREE THOUSAND DOLLARS)

STORM SEWER SERVICES - $1500.00 (FIFTEEN HUNDRED DOLLARS)

WATER AND SEWERAGE AND STORM SEWER SERVICES - $3000.00 (THREE THOUSAND DOLLARS)
Water and Sewer Installation Notice
Applicant Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Applicant Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PID#
Service Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please check applicable type of installation:*

Water OnlySanitary Sewer Lateral OnlyWater and SewerStorm Sewer
Department of Labour Plumbing Permit
Please provide Province of New Brunswick, Department of Labour Plumbing Permit Number:
PLEASE NOTE: Section 13(4) of the Plumbing Installation and Inspection Act states that a municipality shall not permit a sewer or water connection unless a plumbing permit is obtained under this regulation.

For more information on plumbing permit requirements please contact the Department of Labour at 1-506-778-6066.
Please upload a copy of your Department of Labour Plumbing Permit here:

Cancelof
If this office does not receive the plumbing permit whenthe application fee is paid, the customer must return with acopy of the permit prior to inspection.

I understand
Applicant's Signature

Clear
Should be Empty:

SCHEDULE “A” APPLICATION TO CONVERT TO CITY OF MIRAMICHI WATER AND SEWAGE SYSTEM

CITY OF MIRAMICHI APPLICATION FEES ARE AS FOLLOWS:

Water and Sewer Installation Notice

Department of Labour Plumbing Permit