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ENTRANCE APPLICATION FOR SERVICE CONNECTION
ENTRANCE APPLICATION FOR SERVICE CONNECTION
.
2024-06-28T08:58:39-04:00
If you are human, leave this field blank.
ENTRANCE APPLICATION FOR SERVICE CONNECTION
PROPERTY INFORMATION
Proposed Service Location
Street Address:
*
Tax Map/Lot:
*
PROPERTY OWNER INFORMATION
Name:
*
(As listed on Deed/Tax Documents)
Mailing Address:
*
Country
United States (US)
United Kingdom (UK)
Canada
Australia
---
Afghanistan
Åland Islands
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Zip code
Phone #:
*
Email
Bill/Notification Preferences
*
Select how you'd like to receive bills/notices from MVD (must select at least one)
Phone Call
Email
Regular Mail (Paper)
CONTRACTOR/BUILDER INFORMATION
(
if applicable)
Company Name:
Contact Person:
Phone #:
Email:
SERVICE DETAILS
What type of location is this for...?
*
Domestic (Residential)
Commercial
Industrial
Is this New or Upgraded Water Service...?
*
New
Upgrade Existing
Will this location have Fire Sprinkler Service...?
*
No
Yes (List Size of Service Line):
ADDITIONAL INFORMATION/NOTES
Please type any additional information/notes in the section below:
TERMS AND CONDITIONS
This Water & Fire Sprinkler Service Entrance Application is to acknowledge and confirm the Terms of Merrimack Village District’s (MVD) Conditions for service entrances (connection). The undersigned is applying for installation of a service connection at the parcel referenced herein and acknowledges, understands, and agrees to the following 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 application and that upon acceptance hereof, this application shall constitute a contract biding upon the parties, their heirs, successors and assigns. Cost is based upon MVD 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 service has not been installed, 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 service connection and/or expansion installation (water main extension). The property owner is liable for all cost of collections of this Water and Fire Sprinkler Service Entrance Application, including attorney’s fees. If the water service is not installed within six (6) months from the date of this application, the entrance fee and system development charge will be refunded at the applicant’s request. Fees associated with service connection are based upon a trenchless installation from the water main to the edge of the right-of-way. Should this method be unsuccessful, additional cost must be paid by the applicant. Should the roadway be damaged during installation, additional fees will be charged for repairs. Frost, ledge, abnormal barriers, bridging of water and the like are not included in the cost; there will be additional charges should they be encountered. MVD is required to comply with the Town of Merrimack’s (the Town) requirements. Due to this, service connections may be subject to approval from the Town. If approval is not obtained, MVD will be unable to provide service connection. MVD's availability and installation of parts/services is subject to vary due to issues beyond our control including but not limited to supply chain and delivery delays. MVD shall not be liable for any issues or damages occasioned by delay beyond their control. It is the property owner’s responsibility to ensure compliance with MVD’s By-Laws and Schedule of Rates (copies of each document can be found on our website www.mvdwater.org or requested by contacting the MVD office). Per MVD By-Law 1.B.
“Whether or not a signed application for service is made by the customer and accepted by the District, the rendering of the service by the District and its use by the customer, shall be deemed a contract between the parties, subject to all provisions of the tariff applicable to the service.”
Bills and payment will be the responsibility of the property owner as listed on the current deed recorded with the Hillsborough County Registry of Deeds and as reflected in the Town of Merrimack, NH Tax Records. MVD bills the property owner as listed on the current deed recorded with the Hillsborough County Registry of Deeds and reflected in the Town of Merrimack, NH Tax Records. MVD must be contacted by phone or email to change ownership of property. Merrimack Village District (MVD) bills the property owner as listed on the current deed recorded with the Hillsborough County Registry of Deeds and reflected in the Town of Merrimack, NH Tax Records. Please note the following information for service locations that are rented to and/or occupied by tenant(s): Tenants are permitted to transfer service to an account in their name that is separate from the property owner’s account in order to make payment of bills; this does not relieve the property owner of any responsibility for the service or payment of service to MVD. Leases/rental agreements between property owners & tenants/occupants are not recognized by MVD; the property owner is responsible for the service and payment of service provided by MVD regardless of any leases/rental agreements between property owners & tenants/occupants. MVD does not perform readings or billings for move-in/move-outs at rental properties. Service transfers to/from a tenant/owner account will only be processed during the regular monthly billing and will not be prorated for move-in/move-out or occupancy/lease dates. The proposed service line(s) (portion of pipe connecting from MVD’s curb box to the inside of the building) shall meet all of MVD’s required specifications, including but not limited to the kind, type, and size. MVD has the right to inspect all work; including prior to commencement, during (prior to backfill), and upon completion. MVD provides service under the expectation that any and all plumbing is installed and maintained per International Plumbing Codes. Note: Any location determined to have water pressure over 80 psi is required to install and maintain a pressure reducing valve (refer to International Plumbing Code 604.8 Water Pressure-Reducing Valve or Regulator). Additionally, any location having direct pressure hot water tanks or appliances must place proper automatic vacuum relief valves in the pipe system to prevent any damage to such tanks or appliances in the event of water shut-off (refer to International Plumbing Code 606.5.9.). Service provided to locations with over 80 psi and/or having direct pressure installations are at the property owner’s own risk and in no case will MVD be liable for any damages occasioned thereby. The property owner owns and is responsible for any and all maintenance, required repairs and/or replacements of the service line, as well as all plumbing and fixtures. MVD owns and is responsible to maintain the curb box (shut-off valve for the service line-located in the street or at/near the property line), the service tap (the portion of pipe that connects the water main to the curb box) and the water meter & remote meter reading devices.
Name of Person Completing Form
*
Phone
Confirmation & Agreement
*
By checking this box, I confirm that I have read & understand and agree to the Water Service and Fire Sprinkler Entrance Application Terms & Conditions
Captcha
*
reCAPTCHA is required.
SUBMIT
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
.
Note: This Application for Service Connection is for
NEW
water or fire sprinkler services to be installed or upgraded. If you are purchasing a property that is already connected to MVD please click
here
.
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