appendix 1 residential connection form and permit application

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For MCWD only: Date Received: Meter Installation Approval Date: By: By: District Engineer Water Equivalent Dwelling Units (EDU): Proposed Total Dwelling Units: Existing Dwelling Units: Net Increase in Dwelling Units: Net Water EDU's Due: Water Meter Size: If reducing EDU count, no charge :Sewer Equivalent Dwelling Units (EDU) :Proposed Total Dwelling Units :Existing Dwelling Units :Net Increase in Dwelling Units :Net Sewer EDU's Due Fees and Capacity Charges Calculations: Svc Area: Fees Fee Schedule No. Units Extension Preliminary Project Review Fee, New Residence $ 500.00 $ Preliminary i Review Fee, Addition/Rennovation i i $ 200.00 $ Additional Review Fees (actual cost) $ $ Water Permit Fee $ 30.00 $ Sewer Permit Fee $ 30.00 $ Water Meter Installation Fee: $ $ Water Capacity Charge (see EDU calcs below): $ $ Sewer Capacity Charge (see EDU calcs below): $ $ Construction Inspection (single lot): $ 400.00 $ Construction Inspection (large project): $ 500.00 $ * Total Additional Review Fees: Reviewer: Hours: Rate: Subtotal: District Engineer $ 105.00 $ Capital Projects Manager $ 85.00 $ Project Engineer $ 68.00 $ Associate Engineer $ 63.00 $ Consultants $ Total $ * Fee estimate not final until reviewed by MCWD staff. June 2009 3 of 3
MARINA COAST WATER DISTRICT 11 Reservation Road, Marina CA 93933 (831) 384-6131 RESIDENTIAL IRRIGATION CONNECTION FORM AND PERMIT APPLICATION NOTE: When approved and signed by the jurisdiction, this form must be submitted with final and complete construction plans to the Marina Coast Water District permit office. Completing the Residential Irrigation Connection Form & Permit Application does not guarantee issuance of a permit. ALL SPACES BELOW MUST BE COMPLETED OR THE APPLICATION MAY NOT BE PROCESSED. (Please print clearly.) PROPERTY INFORMATION Property Owner: Owner's Telephone Number: Agent/Representative: Agent's Telephone Number: Property Address: Mailing Address (if different from property): Assessor's Parcel Number: Rehabilitated Landscape requiring a permit (Y/N) DESCRIPTION OF AREA SERVED Development Name (Address): Irrigation Meters Required (enter quantity): List of Parcels/Lots Served By Meter(s): Map of area served attached (Y/N) (map must identify the Parcels/Lots served by the Connection) ACREAGES OF AREA SERVED (1-acre = 43,560-feet-squared) Proposed Existing Acres Ft 2 Acres Ft 2 Total Project Area: Area of Structures, Hardscape: Area of Non-irrigated Open Space: Landscape Area (irrigated planting area): A) Landscape Plantings (non-turf): B) Ornamental Turf: C) Special Landscape Area (recreational turf): CONVERTING ACREAGES TO EQUIVALENT DWELLING UNITS Acreage Change Summary Irrigated Landscape Category Proposed (acres) Existing (acres) Change (acres) Landscape (non-turf) Ornamental Turf Special Landscape Area (recreational turf) Acreage to Demand (in acre-feet per year - AFY) Irrigated Landscape Category Change (acres) Water Use (AFY) Landscape (non-turf) Ornamental Turf Special Landscape Area (recreational turf) June 2009 1 of 3
Page 1 and 2: APPENDIX 1 RESIDENTIAL CONNECTION F
Page 3: No. Fixture Units per Total Fixture
Page 7 and 8: Backflow Devices: Irrigation: Size:
Page 9 and 10: MARINA COAST WATER DISTRICT 11 Rese
Page 11 and 12: TABLE NO. 2 - POST-PROJECT PROPERTY
Page 13 and 14: Fees and Capacity Charges Calculati
Page 15 and 16: EXAMPLE CONSTRUCTION AND TRANSFER O
Page 17 and 18: EXAMPLE CONSTRUCTION AND TRANSFER O
Page 19 and 20: EXAMPLE this Agreement, and the In-
Page 21 and 22: EXAMPLE services in the amount of $
Page 23 and 24: EXAMPLE 11.1.2 A complete, detailed
Page 25 and 26: EXAMPLE 16. No Water, Recycled Wate
Page 27 and 28: EXAMPLE NOTICE: IN AGREEING TO THE
Page 29 and 30: EXAMPLE 28. Exhibits 28.1 All exhib
Page 31 and 32: EXAMPLE EXHIBIT A CITY RESOLUTION M
Page 33 and 34: EXAMPLE EXHIBIT C MAP OF DEVELOPMEN
Page 35 and 36: EXAMPLE of concern (“MEC”). All
Page 37 and 38: EXAMPLE Deductibles and Self-Insure
Page 39 and 40: EXAMPLE EXHIBIT E NOTICE TO BUYERS
Page 41 and 42: Date Development Company, LLC Attn:
Page 43 and 44: APPENDIX 5 CHECKLIST FOR PLAN CHECK
Page 45 and 46: PART A: ADMINISTRATIVE REQUIREMENTS
Page 47 and 48: Footnotes 1. The MCWD Code Section
Page 49 and 50: No. Item App. B-10 If the plans are
Page 51 and 52: No. Item App. B-28 Is there a City
Page 53 and 54: PART C: REQUIREMENTS FOR DOMESTIC (
Page 55 and 56:
No. Item App. Rev. Init. Reviewer C
Page 57 and 58:
PART D: REQUIREMENTS FOR RECYCLED W
Page 59 and 60:
No. Item App. D-15 Water service la
Page 61 and 62:
No. Item App. b) Correct material (
Page 63 and 64:
PART F: REQUIREMENTS FOR SUBDIVISIO
Page 65 and 66:
No. Item App. G-03 Has an Irrigatio
Page 67 and 68:
PART H: WATER CONSERVING APPLIANCES
Page 69 and 70:
PART I: REQUIREMENTS FOR HOT WATER
Page 71 and 72:
APPENDIX 6 BOND WORKSHEET
Page 73 and 74:
DOMESTIC WATER, SEWER, RECYCLED WAT
Page 75 and 76:
APPENDIX 7 DEVELOPER’S REQUIRED I
Page 77 and 78:
APPENDIX 8 CONSTRUCTION PERMIT APPL
Page 79 and 80:
APPENDIX 9 COST OF CONSTRUCTION STA
Page 81 and 82:
Marina Coast Water 11 Reservation R
Page 83 and 84:
APPENDIX 10 BILLS OF SALE (DOMESTIC
Page 85 and 86:
IN WITNESS WHEREOF, the other parti
Page 87 and 88:
Marina Coast Water 11 Reservation R
Page 89 and 90:
EXHIBIT A - PROPERTY DESCRIPTION Ap
Page 91 and 92:
IN WITNESS WHEREOF, the other parti
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