Step by Step Application Process

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Narragansett Bay Commission Checklist An application is complete and will be reviewed by the Narragansett Bay Commission only if the following items are submitted: Step by Step Application Process Please follow the steps below to submit your application: 1. Complete the application form (pages 1 through 4) in its entirety and with the appropriate signatures. Please Note: The Applicant information listed in item 1, should name the person responsible for the Sewer Connection Permit (i.e. the property owner or drain layer). 2. Please be sure to submit the number of bedrooms. 3. Required Plan(s): Residential (Single Family and Residential Complex up to 6 units). Please submit one (1) Copy of a Site plan that includes house location, utilities, plat & lot number(s), street address, and location of sewer connection from house to the street (See attached sample). 4. Please submit this permit application with the fee payable by check or money order to the Narragansett Bay Commission (NBC). This fee is applicable to all applications for a sewer connection, either connecting directly or indirectly to NBC facilities. The fee is payable at the time of application. $260 PER HOUSE CONNECTION No sewer connection permit application will be processed without the appropriate fees. Any questions regarding this application, please contact Ms. Tina Moretti at Narragansett Bay Commission Permitting Section at (401) 461-8848 extension 353. Applications can be mailed to: Narragansett Bay Commission, Permit Section, One Service Road, Providence, RI 02905. Did you know that you can electronically file your application and pay your application fee online? Visit http://permits.narrabay.com to file and pay online.

1. Permittee: (Please do not use Engineering/Consulting Firm Name) Company Name (if applicable): Address: City/Town: State: Zip: _ Telephone #: (Bus.) (Cell) E-mail Address: 2. Property Owner: (if other than Permittee) Company Name (if applicable): Address: City/Town: State: Zip: Telephone #: (Bus.) (Cell) E-mail Address: 3. Property Description: Is the property part of a new subdivision? YES NO Provide a sketch or map identifying the property location with street names and/or plat & lot number(s). See attached sample. Project Name (if applicable): Property Address*: City/Town: Plat No.(s): Lot No.(s): *If a street address has not been assigned, the Applicant will be required to submit the street address prior to discharging from the connection. Does this property have an existing sewer connection? YES NO 4. Reason for Connection: Existing house with no prior sewer connection New construction of house Renovation or Addition to existing house Change of use for house (Increase of flow greater than 20%) (Increase of flow greater than 20%)

5. House Description: (Provide floor plan(s), site plan showing location of house on property- see attached sample) No. of Building(s) Total No. of Dwelling Unit(s) 6. Wastewater Generation: What is the total number of bedrooms in the house? OFFICE USE ONLY Estimated average daily flow: gpd. Estimated peak daily flow: gpd Initial: What is the source of water to the premises? (check the appropriate boxes) MUNICIPALITY RIVER/STREAM WELL OTHER 7. Construction: What are the approximate starting and finishing dates of construction? Start : Finish : Drain Layer information: License Number: Company: Address: City/Town: State: Zip: Telephone: (Bus.) E-mail Address Drain Layer s Bond Company. Company: Address: City/Town: State: Zip: Amount of Bond: Telephone (Bus.)

8. Construction Process: Will there be site remediation/dewatering associated with this project that will be discharged to the public sewer system. If YES, a NBC Stormwater permit will be required. YES NO 9. Sewer Extension Approval: Will the proposed sewer connection(s) require an extension of the public sewer to reach your house? YES NO If YES, this application must be signed below by an authorized representative of the City or Town confirming that the proposed sewer extension will conform to the City or Town RI DEM approved Facility Plan. Signature of Authorized City or Town Agent 10. Required Signatures: If this is approved, the undersigned applicant agrees to accept and abide by all provisions of the Narragansett Bay Commission's Rules and Regulations for the Use of Wastewater Facilities within the Narragansett Bay Commission District, as amended, and shall in every respect conform to the terms of this application. Any changes to the information in this must be reported to the Narragansett Bay Commission. Signature of Property Owner Signature of Drain Layer Note: Once the permit is approved, it will be mailed to the Permittee and emailed to the Drain Layer. Please be sure to have this information on the application.

SAMPLE SITE PLAN Plat: Lot: HOUSE GARAGE Sewer line from house to street PROVIDE SIZE OF PIPE AND PIPE MATERIAL Sewer Line Sewer Connection in street PROVIDE CONSTRUCTION DETAILS Water Line Street