WARREN TOWNSHIP SEWERAGE AUTHORITY

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WARREN TOWNSHIP SEWERAGE AUTHORITY 46 Mountain Blvd., Warren, New Jersey 07059 (908) 753-8000 * Fax (908) 753-6893 Application for Final Approval of sanitary sewers Attached is an application for the Final Approval of newly constructed sanitary sewers in the Township of Warren, and allowing such connection to discharge wastewater to the sanitary sewer system. This application form is utilized for both residential and non-residential properties. This is the second step of the two-step application process for the approval of new sanitary sewers. Final Approval is granted by the Authority only after review and approval of this Application Package and supporting documents (specified below), including the Engineer's Certification of Completion of Construction. 1. This application is subject to all of the Rules and Regulations of the Authority, including but not limited to those listed on this application, and by submission of this application, applicant and owner agree to be bound by same. A copy of the Authority s Rules and Regulations are available for review and purchase from the Warren Township Sewerage Authority Office. 2. Applications will only be heard by the Authority at the Work/Public Meeting held generally on the third (3rd) Wednesday of each month. 3. Filing deadline is thirty (30) days prior to the meeting date. (No exceptions) 4. The following items are needed by the Secretary of the Warren Township Sewerage Authority to complete the application process: - Original Application - One Copy of Application - Two (2) sets of Licensed Engineer Plans - Filing Fee (Separate Check) - Escrow Fee (Separate Check) - In addition to all items required by the Authority s Rules and Regulations Article 3.4.6, Certification of Completion of Construction and Article 3.5.1, Final Approval. 5. Application filing fee: Final $100 per EDU (No exceptions) 6. As set forth in the Authority s Rules and Regulations Article 3.13 et. seq., an escrow fee must accompany an application in addition to the application filing fee. The escrow fee shall be used to cover costs of professional services incurred in connection with the review of applications, review and preparation of documents and inspection of improvements. The costs incurred may be more or less than the escrow amount. If the escrow account contains insufficient funds to enable the Authority to perform these reviews and inspections, an additional escrow amount will be established by the Authority and must be posted by the applicant within 14 days of the issuance of the notice. The Authority will FA 1 of 8 rev 8/2003

discontinue any action on this and any other of applicant s applications or inspections and will not issue any permits if the escrow fund is not restored within 14 days of the Authority s request for additional funds. If the total review costs are less, the remainder of the escrow account will be refunded pursuant to N.J.S.A. 40:14A-41. For Escrow Fees See Schedule B to the Authority s Rules and Regulations. 7. If a sewer plug was installed during construction, applicant is required, prior to the issuance of a connection permit, to provide a signed Certification of Removal of the sewer pressure plug on the form provided by the Authority. Failure to remove the pressure plug will subject applicant to the penalties set forth in the Authority s Rules and Regulations Article 3.5.1 (h). 8. Applicant and owner recognize that any approval granted will be based in part upon a determination of the projected sewage flow of the project. That projection will be made on the basis of the information provided in the application, including the description of the proposed use of the building(s). The applicant and owner acknowledge and agree, pursuant to the Authority Rules and Regulations, Article 5.8, that in the event that such use changes or the actual water consumption and associated sewage flow exceeds such projection, the Authority has the right to require the applicant, or then current owner or user, to submit an amended their application and to recalculate the connection fee, the Authority will then charge the equivalent to the then applicable connection fee for such additional flow and will base the sewer use fee on such greater flow. Escrow $1500.00 FA 2 of 8 rev 8/2003

Application for Final Approval of the Constructed Sanitary Sewers and Permit to Connect (per Article 3.5) DATE RECEIVED APPLICATION NO. ESCROW ACCT. NO. 1) Address of Project: 2) Applicant's Name: Mailing Address: Phone #: Home:( ) Work: ( ) Fax: ( ) 3) Property Description: Block # Lot # Zoning District Sewer service area Total of Acreage Total Sq. Ftg.(commercial) Number of units (residential) Easements and rights-of-way 4) Date and resolution number of preliminary sewer construction approval: 5) Approved capacity (# of equivalent dwelling units) 6) Indicate all revisions made to plans since Preliminary Approval as well as the date of the revisions. 7) Status of application before Land Use Board (indicate if application is preliminary or final, as well as the date application was filed with the respective Land Use Board). 8) Does applicant and/or owner agree to convey by deed to the Authority easements to all areas on Preliminary plan showing sanitary sewer and all rights to sewer system? 9) Estimated cost of construction FA 3 of 8 rev 8/2003

FA 4 of 8 rev 8/2003

10) Name, address, telephone and fax # of Attorney 11) Name, address, telephone and fax # of Engineer 12) List all supportive documents being submitted with application (include date of plans and reports, who prepared, etc.) By signing below applicant certifies to the accuracy of the information in this application and states that it understands the Authority s Rules and Regulations and agrees to be bound thereby. Signature of applicant Date Make all checks payable to Warren Township Sewerage Authority or WTSA FA 5 of 8 rev 8/2003

WARREN TOWNSHIP SEWERAGE AUTHORITY 46 Mountain Blvd., Warren, New Jersey 07059 (908) 753-8000 * Fax (908) 753-6893 Escrow Agreement (Application for Final Approval) The undersigned applicant hereby agrees that if the Escrow Amount submitted with this application is not sufficient to cover professional charges and/or fees, he/she will provide additional funds as deemed necessary by the Authority's Secretary in accordance with the Authority s Rules and Regulations Article 3.13 et. seq. (available for review and purchase in the WTSA office). In the event it is determined that escrow funds in addition to the initial deposit are required, the Secretary to the Authority shall notify the applicant. The applicant agrees to pay the additional escrow within fourteen (14) days of said notice. Applicant further agrees and acknowledges that if the aforesaid additional escrow funds are not paid within the time specified, all processing of the applicant's application on this and any other application submitted by the applicant or owner will be terminated until the payment is made in full. In any event, no construction permit or Certificate of Occupancy will be issued by the Construction Code Official of the Township of Warren until such time that the applicant has posted all outstanding balances to cover all escrow charges with the Authority. In the event amounts deposited in said escrow account shall be in excess of the amount required for review and inspections, the excess funds shall be returned to the applicant after completion of the project and upon the written request of the applicant, pursuant to N.J.S.A. 40:14A-41. If, however, no request for release is received, the monies shall remain in the escrow account until issuance of a Certificate of Occupancy, at which time the unused monies shall be released. I, the applicant, as signed below, have carefully read and understand the above Escrow Agreement and hereby agree to abide by the conditions set forth herein. I further understand that should I not abide by these conditions summary collection proceedings may be initiated by the Warren Township Sewerage Authority. Date Applicant's Signature Tax ID # or Social Sec. #** to law. **Taxpayer's Identification Number must be provided for all escrow deposits in excess of $5,000.00 according FA 6 of 8 rev 8/2003

WARREN TOWNSHIP SEWERAGE AUTHORITY 46 Mountain Blvd., Warren, New Jersey 07059 (908) 753-8000 * Fax (908) 753-6893 Consent of Property Owner (Final Approval) I (We),, the undersigned, presently residing at, in the Township of, County of, State of, do hereby certify the I (We) am (are) the owner (s) of the property situated at, in the Township of Warren, also know as Block(s), Lot(s) as designated on the Tax Map of the Township of Warren. (Hereinafter the Owners ). By virtue of this certificate, the Owners do hereby consent to the making of this application by and to its subsequent approval. Owners hereby acknowledge that Owners have read the completed application and believe to the best of their knowledge that the information contained therein is accurate. Owners understand and agree that this application is governed by the Authority s Rules and Regulations and agree to be bound by same. Owners further understand that the Applicant has deposited with the Authority escrow fees in connection with the application pursuant to the Authority s Rules and Regulations and applicable statutes, such fees are for the costs incurred for services of professional retained by the Authority to review the application, draft documents and inspect any required construction. Owners are further aware that additional fees may be required by the Authority in connection with the application. If additional escrow fees are required and have not been paid by the Applicant, Owners understand and agree that as the property owner(s) I (we) will become responsible for the payment of such fees. Date Signature of Owner(s) Sworn to and subscribe to before me in the State of New Jersey Notary Public FA 7 of 8 rev 8/2003

Check-List for a Final Approval: - Prepare documents outlined in the Final Approval Application with required fees and plans. This application follows the Preliminary Application. All supporting documents are needed to verify that all terms & conditions of the Preliminary approval are completed and satisfied. - Deliver documents 30 days prior to the Authority s Work/Public Meeting. - If application is approved, a resolution granting Final Approval will be prepared for the next Public Meeting - The resolution will be forwarded to the applicant, engineer and/or attorney approximately three days after the meeting allowing the applicant to proceed with the proper department in the township. - After the Final Approval is given the applicant may request that the escrow account be closed, subject to all billing being satisfied. During this time the applicant can then complete the needed requirements with the Planning Board and Construction Department. The Authority will then be allowed to sign the Compliance Review file from the Planning Board, which will allow for the CO to be given from the Construction Department. - FINAL APPROVAL MUST BE OBTAINED BEFORE ANY CONNECTIONS MAY BE MADE. Unless otherwise provided, Final Approval shall constitute formal acceptance of any sanitary sewer line extension by the Authority. No connections shall be permitted to any sewer line extension for which Final Approval is required until such FINAL Approval has been granted and the Authority's Engineer has certified to completeness to the NJDEP and submitted forms WQM 005 and 008, or the forms then required, to the NJDEP. H:\Home\Wtsa\Application Forms\App-Fin.Frm.2003.Rev.Doc FA 8 of 8 rev 8/2003