Western Monmouth Utilities Authority

103 Pension Road, Manalapan, NJ 07726

APPLICATION -- PROJECT APPLICATION FOR REVIEW OF PLANS FOR SUBDIVISION OR OTHER DEVELOPMENT IN THE WMUA SERVICE AREA, COUNTY OF MONMOUTH, STATE OF NEW JERSEY.

Date:

Applicant's Email Address:

Confirm Applicant's Email Address *

1. Applicant's Name: *

Address: (Address Line 1)
(Address Line 2)
(City)
(State) (Zip Code)

Phone:

2. Name and Address of present owner (If other than above)

1. Applicant's Name: *

Address: (Address Line 1)
(Address Line 2)
(City)
(State) (Zip Code)

Phone:

3. Interest of applicant if other than owner:

4. Submitted for site-plan approval and/or subdivision approval by Planning Board of Township of:

Enter Township

Enter date submitted for approval:

(Proof of approval by Planning and/or Zoning Board of adjustment is required prior to Application Approval by the WMUA.)

5. Location of subdivision (neighborhood or section name):

Street

Tax Map Block

Lot #

6. Number of proposed lots to be sewered:

7. Area of entire tract:

and portion being sewered:

8. Development Plans:

Sell lots only
Yes
No

Construction of houses for sale
Yes
No

Other:

9. Name of Professional Engineer designing Plan on behalf of Applicant:

Address: (Address Line 1)
(Address Line 2)
(City)
(State) (Zip Code)

C/O

Address: (Address Line 1)
(Address Line 2)
(City)
(State) (Zip Code)

Phone

10. As a condition to Application Approval, Applicant hereby agrees to convey by deed or grant to the WMUA easements to all areas on Plans showing sanitary sewer and all rights to sewer systems, in addition to enter into any required Deed Restrictions and/or Hold Harmless and Indemnification Agreement with the WMUA.

11. Describe your proposal for sewage disposal.

12. As a condition to Application Approval, Applicant will post Performance and Maintenance Guarantees as required by the WMUA.

13. List all plans and other materials accompanying Application and number of each as required by the WMUA Rules and Regulations Section 3(E)(2).

Item

Number

Item

Number

Item

Number

Item

Number

Item

Number

Item

Number

Item

Number

Item

Number

Item

Number

Item

Number

14. Applicant's Engineer's estimate of entire cost of construction, including right-of-way, inspection and as-built plans. Enter estimate amount in box below.

(If estimate is unavailable at this time, Applicant's Engineer shall provide an estimate to the WMUA Engineer as soon as it is ascertainable).

15. Upon Application Approval by the Commissioners, construction on the project shall start within two (2) years of the date of the resolution by the Commissioners granting approval. If construction does not start within two (2) years of the date of such resolution,the approval will automatically expire.

16. The granting by the WMUA of any Application Approval shall in no way operate as a guarantee by the WMUA of capacity to accept the flow of an Applicant. Only at such time as Application Approval is granted by the WMUA, all applicable fees are paid to the WMUA, and all application conditions as set forth in the WMUA Rules and Regulations and the Application Approval Resolution adopted by the Commissioners have been satisfied to the approval of the Commissioners shall the WMUA guarantee capacity to accept the flow of an Applicant. As such,any payments shall be non-refundable.

17. The Applicant shall pay to the WMUA $1000 per EDCU, and shall be a minimum of $10,000, which is greater. Such amount shall be placed in an Escrow Account, from which expenses will be paid by voucher. The Escrow Account will cover all engineer review fees and legal review fees. Such escrow amount shall be by cash or other draft acceptable at the discretion of the WMUA. If so required by the WMUA, additional deposits into the Applicant's Escrow Account shall be made by the Applicant to meet expenses within fifteen (15) days of the date of the request by the WMUA. The Application process shall not continue until such requirement is met. The Applicant shall pay all costs incurred by the WMUA on the Applicant's project. See the WMUA Rules and Regulations for more information.

18. The Applicant shall indemnify the WMUA, its agents and employees, and hold it harmless from and against all liabilities, losses or damages incurred with respect to any action the WMUA may take with respect to the Escrow Account with the exception of liabilities, losses or damages solely caused by negligent acts, omissions, errors or willful misconduct by the WMUA.

19. The Applicant acknowledges that upon its request of release of any performance guarantees and/or cash sureties, if there are any Application deficiencies and/or bills not paid, the WMUA is authorized by the Applicant to apply any balance remaining in the cash sureties for those Items. Any balance remaining thereafter, including Interest, shall be refunded to the Applicant.

20. Failure to pay connection fees when due will subject the property to a lien and/or foreclosure and sale as in any case with any taxes due on realty. The applicant will be responsible for any and all attorney's fees and costs of recovering unpaid service and/or connection fees.

21. Upon receipt of an Application,the WMUA shall assign the Application a project number. Such project number shall be referenced in all future correspondence between the Applicant and the WMUA.

The undersigned hereby makes application to the Western Monmouth Utilities Authority (WMUA) for sewer service at the premises described above beginning the above date. In making this application, the undersigned agrees to abide by the WMUA Rules and Regulations, a copy of which is kept at the WMUA's office and is available for examination upon request during normal business hours, and be held responsible for attorney fees and costs in the event the WMUA has to partake in any lawsuit relating to the Application.

It is acknowledged that the discharge of surface or ground water from sump pumps, cellar drains, gutters or area drains is not permissible. The undersigned further agrees to give the WMUA ten (10) days written notice of its intention to sell the above property, furnishing the WMUA with the full name of the new owner, that he will settle with the new owner any adjustment due on prepaid sewer charges.

Notwithstanding any agreement between the owner of the subject premises and the occupant of the subject premises, the service charges are the responsibility of the owner of the property. Failure to pay same when due will subject the property lo a lien and/or foreclosure and sale as in any case with any taxes due on realty. The applicant will be responsible for any and all attorney's fees and costs of recovering unpaid service and/or connection fees.

MAKE ALL CHECKS PAYABLE TO THE WMUA

Electronic Signature Disclosure and Consent Statement

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You further acknowledge and agree that the taking of any such actions by you evidence your intent to sign any such agreement, acknowledgment, consent, fromterms, disclosures or conditions.

You also agree that no certification authority or other third party verification is necessary to the validity of your electronic signature; and that the lack of such certification or third party verification will not in any way affect the enforceability of your signature or any resulting contract.

I, the applicant for/on this APPLICATION FOR REVIEW OF PLANS FOR SUBDIVISION OR OTHER DEVELOPMENT, warrant the truthfulness of the information provided in this application. Please type your Legal First and Last Name below. *

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree that I have typed my name and checked the box myself. *
Check box to submit your electronic signature

Date *