Sewer-Permit-Applica.. - the City of Hopewell Virginia

City of Hopewell
Bureau of Fire Division of Code Enforcement
200 S. Hopewell St., Hopewell, VA 23860 (804) 541-2226 Fax (804) 541-2309
APPLICATION & AGREEMENT FOR A SEWER CONNECTION PERMIT
It is understood with submittal of this application that all work and materials used in this installation shall conform strictly with the City
of Hopewell ordinances and it must comply with all provisions of the Plumbing Code. This permit covers sewer line connections only.
A plumbing permit shall be secured for all work accomplished within private property. All sewer taps will be made in accordance with
the City of Hopewell Engineering specifications and must be inspected and approved by the Division of Code Enforcement.
LOCATION OF WORK
OWNER:
Date of Application: __________________________ Name: _______________________________________
Address: ____________________________________ Address: _____________________________________
Lot__________Block_________Sub______________ City, State, Zip: ________________________________
Phone: 804 - __________________________________
Email:________________________________________
Building Use: Res Comm Ind Other______ Contact Person:_________________________________
CONTRACTOR:
Contractor: __________________________________ State License: __________________________________
Address: ____________________________________ City License: ___________________________________
City, State, Zip: ______________________________ Business Phone: ______________Cell Phone:_________
Contact Person:__________________________________
Mechanics lien Agent: _________________________________________________________________________________
Address: (City, State, Zip): _____________________________________________________________________________
Select ONE (1) of the following:
Sewer Connection to existing approved sewer lateral ___
Sewer Connection to new subdivision where already installed by a developer ___
Select ONE (1) of the following:
Sewer Connection with Curb & Gutter replacement no sidewalk (B&A) ___
Sewer Connection with Curb, Gutter & Sidewalk replacement (A, B & C) ___
Sewer Connection with No Curb, Gutter or Sidewalk replacement, Asphalt ONLY (A) ___
Standard cut of curb & gutter is 10’ long, sidewalk is 4’x5’ section and standard asphalt pavement replacement is 2’x10’. Should
curb, gutter, sidewalk and/or asphalt pavement exceed above dimensions, additional charges will be incurred and billed to
applicant. Performance bond may be required in the amount of $______. It is understood that this is an application for a Sewer
Permit and that work may not begin until the official permit has been issued.
Signature of Applicant:_____________________________
Date:____________________________________________
Official Use Only
Permit #___________________ Permit Fees $______________ Check Cash Fee Table Information
Sub/Parcel #________________ Lot / Block _______________ Zoning_______ A__B__C__
New___Existing___
Building Official Approval:________________________________ Date:_________
City Engineer Approval: __________________________________ Date:_________
HRWTF Approval: ______________________________________ Date:_________
Page 1 of 2

Please select connection type and enter # of units.
Connection Type Number of Units
Residential Single Dwelling
Residential Duplex (per apartment)
Hotel or Motel (per room)
Restaurant
Hospital (per bed)
Nursing Home (per bed)
Laundromat (per washer)
Church
Theater
Service Station
Service Station (Car Wash)
Office Building (per 5,000 SF)
Jails (per bed)
Please select meter size if applicable.
Meter Size Mark (X)
5/8 inch
3/4 inch
1 inch
1½ inch
2 inch
3 inch
4 inch
6 inch
8 inch
10 inch
Code Enforcement Connection Fees
Sewer Capital Fees
Total Fees
011.1303018.0000.000.000
031.1303018.0000.000.000
$__________
$__________
$__________
Page 2 of 2

CITY OF HOPEWELL SANITARY SEWER SYSTEM
WASTEWATER CONNECTION FEES BY TYPE
ALLOCATED ON BASIS OF EQUIVALENT RESIDENTIAL UNIT*
Connection Type Units Price per unit
Residential Single Dwelling 1 $2,026
Residential Duplex (per apartment) 1 $2,026
Hotel or Motel (per room) .5 $1,013
Restaurant 3 $6,078
Hospital (per bed) 2 $4,052
Nursing Home (per bed) .5 $1,013
Laundromat (per washer) .2 $405
Church 1 $2,026
Theater 2 $4,052
Service Station 1 $2,026
Service Station (Car Wash) 2 $4,052
Office Building (per 5,000 SF) 1 $2,026
Jails (per bed) .5 $1,013
*Equivalent Residential unit is a measure where one unit is equivalent to wastewater effluent from one
home, which is 250 gallons per day per home. This amount is based on most wastewater pollution
textbooks estimating an average of 100 gallons per day per person and the national home average of 2.5
persons.
WASTEWATER CONNECTION FEES BY SIZE
WASTEWATER METER EQUIVALENCY RATIOS
METER SIZE
EQUIVALENCY CONNECTION FEE
RATIO**
5/8 inch 1.00 $2,026
3/4 inch 1.50 $3,039
1 inch 2.50 $5,065
1½ inch 5.00 $10,130
2 inch 8.00 $16,208
3 inch 16.00 $32,416
4 inch 25.00 $50,650
6 inch 50.00 $101,300
8 inch 80.00 $162,080
10 inch 115.00 $232,990
FOR THOSE CONNECTIONS LARGER THAN 6 INCHES, APPLICATIONS MUST BE MADE
DIRECTLY TO THE HRWTF DIRECTOR WHO WILL EVALUATE THE PROPOSED
CONNECTION AND MAKE THE FINAL DETERMINATION FOR APPROVAL
**Based on American Water Works Manual M1-Meter Capacity Ratios