NBC
Application

Step 1 of 10

Applicant Information

Contact information for the applicant of the sewer connection permit.

Email
*
Salutation
First Name
*
Last Name
*
Company Name
Street Address
*
City
*
State
Zip
*
Home Phone - Home and/or Work Phone is required.
Work Phone
Fax Phone

Step 2 of 10

Property Owner Information

Contact information for the property owner. Simply click the "Copy Applicant's Information" link if the information is the same.

Salutation
First Name
*
Last Name
*
Company Name
Street Address
*
City
*
State
Zip
*
Home Phone
Work Phone
Fax Phone

Step 3 of 10

Billing Recipient Information

Billing information for the person who should receive the bill.

Salutation
First Name
*
Last Name
*
Company Name
Street Address
*
City
*
State
Zip
*
Home Phone
Work Phone
Fax Phone

Step 4 of 10

Notification Receipient Information

Address information for the person who should receive notification for the server connection permit application.

Salutation
First Name
*
Last Name
*
Company Name
Street Address
*
City
*
State
Zip
*
Home Phone
Work Phone
Fax Phone

Step 5 of 10

Property Description

Is the property part of a new subdivision?

Property Street Address
*
City/Town
*
Plat Number(s)
Lot Number(s)

Step 6 of 10

Building Description

Building Type Help
No. of Commercial Connections
*
No. of Commercial Buildings
*
No. of Commercial Offices
*
Seating Capacity Help
*
Bedding Capacity Help
*
Commercial Operation & Special Equipment
No. of Industrial Connections
*
No. of Industrial Buildings
*
No. of Work Stations
*
No. of Residential Connections
*
No. of Residential Buildings
*
No. of Dwelling Units
*
Site Remediation/Dewatering Help

Reason for Connection

Step 7 of 10

Plumbing Fixtures

Please add all the different types of plumbing fixtures you have and how many you propose to add. You can skip this step if you have no plumbing fixtures.

Total Current Proposed
 Remove
Total Current Proposed
 Remove
Total Current Proposed
 Remove
Add Add Click to add a new Plumbing Fixture

Step 8 of 10

Stormwater & Construction Information

Max No. of Occupants
No. of Bedrooms (if applicable)
Estimated Avg. Daily Flow (Gal/Day)
Click here for guidance
Estimated Peak Flow (Gal/Day)
Premise Source of Water
Approx. Construction Start Date
Approx. Construction Finish Date
Construction requires a sewer extension to public sewer system?

Step 10 of 10

Stormwater Source & Generation

Please select all the sources of stormwater and indicate the total quantity of flow for each time frame.



Pre-Construction Post-Construction
3 mo * *
2 yr * *
10 yr * *
25 yr * *
50 yr * *
100 yr * *

Step 7 of 10

Stormwater Reduction Systems

Please select the differnt types of stormwater reduction systems you are going to use and enter in the amount of each type you wish to complete. You can skip this step if you have no stormwater reduction systems.

Total
 Remove
Add Add Click to add a new Stormwater Reduction System

Step 10 of 10

Construction Information

Approx. Construction Start Date
Approx. Construction Finish Date
Construction requires a sewer extension to public sewer system?

Step 9 of 10

Drain Layer Information

Contact & license information for the drain layer.

Salutation
First Name
Last Name
License Number
Company Name
Street Address
City
State
Zip
Work Phone
Fax Phone

Step 10 of 10

Drain Layer's Bond Company Information

Contact & amount information for the drain layer's bond company.

Company Name
Street Address
City
State
Zip
Bond Amount
Work Phone
Fax Phone

Step 10 of 10

Project Description

In which city or town will the proposed alteration occur?
*
Description of Work
Debris Removal
Approx. Construction Start Date
Approx. Construction Finish Date

Step 7 of 10

Alterations

Please select the differnt types of alterations and enter in the amount of each type you wish to complete. You can skip this step if you have no alterations.

Total
 Remove
Add Add Click to add a new Alteration

Step 9 of 10

Contractor Information

Contact & license information for the contractor.

Salutation
First Name
Last Name
License Number
Company Name
Street Address
City
State
Zip
Work Phone
Fax Phone

Step 10 of 10

Contractor's Bonding Company Information

Contact & amount information for the contractor's bonding company.

Company Name
Street Address
City
State
Zip
ContBond Amount
Work Phone
Fax Phone

Application Confirmation

Confirm Your Submission

Please feel free to go back and review your application before clicking on the Submit Button.