Water Main Extension Application

The following application must be completed prior to any water main extension project.
Once the application is submitted, MVD will review the information & contact the applicant with cost details and approval information.

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WATER MAIN EXTENSION APPLICATION

PROJECT INFORMATION

Road/Street Name: *

Name of Development/Subdivision (if applicable):

Length of Proposed Extension (in feet): *

Proposed Plan and Documents:

If available, please attached the proposed plan and any related documents for the project.

CONTACT INFORMATION

Company Name: *

Mailing Address: *

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Contact Person: *

Phone #: *

Email:

ADDITIONAL INFORMATION/NOTES

Please type any additional information/notes in the section below:

 

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TERMS AND CONDITIONS

This Application for Water Main Extension is to acknowledge and confirm the Terms of Merrimack Village District’s (MVD) Conditions. The proposed Water Main Extension shall meet all of MVD’s required specifications, including but not limited to the kind, type, and size. The parties agree that the abnormal conditions, as specified in Section 7.C. & 7.D. of the MVD By-Laws, shall be deemed to include the removal or circumventing of telephone poles, ledge, frost, trees or water. MVD has full authority of the proposed Water Main Extension Project. NO outside company, contractor, or firm, or the like, will execute ANY work on this project without the PRIOR WRITTEN approval of MVD. MVD has the right to inspect all work; including prior to commencement, during (prior to backfill), and upon completion. MVD is required to comply with the Town of Merrimack’s (the Town) requirements. Due to this, Water Main Extensions and Water Service Connections may be subject to approval from the Town. If approval is not obtained, MVD will be unable to permit the work. MVD shall not be liable for any issues or damages occasioned by delay beyond their control. Prior to the commencement of any work: 

• MVD MUST be contacted 48 hours prior to ANY work.
• MVD must be provided with all applicable plans for all Water Main Extension projects.
• Work will be permitted after the plans have been reviewed and approved by MVD.
• Additionally, Water Main Extension projects that are intended to connect a subdivision(s) will only be permitted upon the above plan review and approval process as well as the receipt of a certified copy of the Subdivision Plan that has been approved by Town of Merrimack’s Planning Board.

Upon completion of the Water Main Extension Project:

• Final record drawings must submitted to MVD before water service is turned on.
• Final measurements of the completed Water Main Extension will be taken and compared to the final record drawings to determine the final cost.

The cost is based upon MVD’s Schedule of Rates; cost will be updated to reflect any changes to the Schedule of Rates. If changes have occurred in the Schedule of Rates and work has not commenced, the fees for the new rate will be applicable and must be paid before service is provided. Payment of all charges as outlined in the MVD Schedule of Rates must be made prior to any water main extension or service connection. Failure to pay any rates, fees or charges as established by MVD’s Board of Commissioners (BOC) will result in non-connection or disconnection of service. The applicant is liable for all cost of collections, including attorney’s fees. The undersigned acknowledges, understands, and agrees to the Terms and Conditions, in accordance with the MVD By-Laws. It is understood that these Terms and Conditions as well as the MVD By-Laws shall apply to this Water Main Extension Application and that upon acceptance hereof, this application shall constitute a contract biding upon the parties, their heirs, successors and assigns.

Confirmation & Agreement *

By checking this box, I confirm that I have read & understand and agree to the Water Main Extension Application Terms & Conditions.

Name of Person Completing Form *

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SUBMIT

 

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Once submitted, MVD review the information and contact you to provide costs details and any other necessary information. Costs, Fees, Charges are based on MVD Schedule of Rates.