Silvercreek Water and Sanitation District

Silvercreek Water and Sanitation District P.O. Box 4014 Silvercreek, CO 80446 (970) 887-2850 www.silvercreekws.net

2018 APPLICATION FOR SEWER AND WATER TAP

Re: Lot:______Block______Subdivision______Street Address:______

Owner:______Telephone:______-______

Billing Address:______

Granby Sanitation District - Sewer Tap $ 8,500.00 Town of Granby - Water Tap $ 6,482.75 Town of Granby - Sewer Tap $ 1,551.22 SilverCreek Water & San District – W & S Tap $ 4,672.00 SilverCreek Inspection Fee $ 100.00 Water Meter, Saddle, etc. $ 620.44 Total $ 21,926.41 – Per Single Family Equivalent (S.F.E.)

I request ______sewer and ______water tap(s) for the above site.

I understand I will be billed quarterly for service charges per the District fee schedule, after 9 months of construction progress. I understand that service charges in the amount of $73.57 per month per water and sewer tap will begin on the date the tap(s) is/are purchased. I understand that when service is used (after 9 months) the service charges will be increased to $77.57 per month per S.F.E. and will be billed quarterly in the amount of $232.68. Of this amount $96.00 is paid to Granby Sanitation District for sewer treatment, $9.50 is paid to the Town of Granby for sewer service, $53.00 is paid to the Town of Granby for water treatment, $35.18 is paid to the Town of Granby for the Water Treatment Plant Debt Fee, and $39.00 is retained by SilverCreek Water and Sanitation District for water and sewer service.

I understand that outside watering, permitted by the Board of Directors, encourages natural grasses / trees / shrubbery be established.

I understand that I am being charged for inspection of the water and sewer tap by the District Inspector, (970) 531- 2321. I agree to have my plumber contact the District for an appointment to: (a) inspect the tap connections to mains (while the ditch is open) and the curb stop, (b) inspect the tap connections to the sewer main and location of clean-outs (while the ditch is open) and (c) inspect the closing and tamping and restoration of the road cut. If later settling requires additional road restoration, I agree to have this work completed within 4 business days. However, if for any reason the District needs to have this work completed, I agree to pay all costs.

I understand and agree that I will be charged, per the District Fee Schedule, for additional family units, apartments, servant quarters, guest houses, swimming pools and hot tubs, and that the payment of one tap fee only allows for the installation of one kitchen as defined by the District's Rules and Regulations (Appendix A).

I agree to provide a copy of my Building Permit within 90 days of the date of the application. If this is not provided, I understand that I may be charged $500.00. The balance of my tap fees may be returned to me and if this occurs this application will be null and void.

______Signature - Site Owner Date

Received this _____ day of ______, 2018. Check No. ______in the amount of $______

______Signature - SilverCreek Water & Sanitation District

Amended February 14, 2017