RESIDENTIAL APPLICATION INSTRUCTIONS

(Single‑Family Residence/Residential Duplex)         

Prior to the construction of any structure with plumbing, or setting up a mobile or modular home, or any other moveable unit that can be used as living quarters on a permanent or temporary basis within our boundaries, you are required to have an approved Sanitary Sewer Service Connection Request and to have paid the New User Facility Fee (NUFF). 

Your completed application with supporting data and a check for the NUFF should be brought to the office (or mailed), and it will be included on the agenda for the first Board of Directors meeting after it is received.  It may be in your best interest to attend the meeting if there are questions or special circumstances that may need to be addressed.  The Board meets ON THE SECOND MONDAY OF EACH MONTH, AT 6:00 PM, IN THE DISTRICT MEETING ROOM LOCATED AT 511 WHISKEY JACK ROAD (except legal holidays, in which case you will need to check with the office).  The Board will review the application for final acceptance.  Connections are not authorized until approved by the Board and (NUFF’s) are paid.

Please notify your Contractor of the following Requirements:

1. Locate Devices are required to be installed at the property line.
2. Pressure line connections must comply with specifications on a separate form.
3. PRIOR TO COVERING the entire lateral and connection into our mainline, it must be inspected by a District Representative.  See the attached inspection form.  You or your contractor/excavator must call KPSD Operations at 290-5979, 24 hours in advance so that a time can be scheduled for your inspection. Leave a message if they are not available. The 24 hours does not include weekends or holiday.
4. A $250.00 penalty will be assessed if the District Representative has not performed an inspection prior to the covering of the line and the tap to the mainline. The line and tap will have to be re-excavated at your expense. 

5. The District inspection is required in addition to the permit required by the State.

If you have any questions, please feel free to call the office.

OFFICE USE ONLY

BOARD APPROVAL

This connection has been accepted by the Kootenai Ponderay Sewer District, subject to the following conditions. 

__________________________________________________________________________________________

__________________________________________________________________________________________

Board Member: ________________________________________   Date: _______________________

Board Member: ________________________________________  Date: _______________________

Board Member: ________________________________________  Date: _______________________

Please complete the following.

I hereby request permission to have a single-family residence service connection installed into the KOOTENAI-PONDERAY SEWER DISTRICT, for the property located at:

Town/Area: Block# Lot#

Physical Address:  

County Tax Number:  

I understand that there will be an administrative fee due in the amount of $10.49 per month, until connection to the District’s system”, after which I will pay the regular monthly sewer charge. I will notify the District office upon connection, and/or of any transfer of property within the District.  I agree to have the connection inspected by the District Field Operations Manager.  I understand that materials and/or labor required to reach the District's line, are NOT included in the New User Facility Fee (NUFF) required by the District.  Any costs associated with physical connection shall be my additional expense.  I agree to notify the District if the property is changed to other than one single-family residence or there is any change in ownership of the building and/or property.

I am enclosing the NUFF (New User Facility Fee) in the amount of $8,894.00 for this single-family residence connection into the Kootenai-Ponderay Sewer District System. (This amount may be less if a property had a previously approved partial payment made or LID paid. Please verify with the District business office.)

This connection will be installed/designed by:
 

My signature certifies that I agree to follow all the requirements, policies and procedures for connection to the District’s wastewater system as stated in the District’s Rules and Regulations and Ordinance and as directed by District Operations and Maintenance staff regarding special requirements.

Applicant: Phone:  

Billing Address:  

Check # Amount:  Receipt #  

Dated:

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Signature Certificate

Document name: Single-Family Residence Sewer Service Connection Request

Unique Document ID: 08f0cceeebbc380db611ede6c47aa2b5cab408ae

Build. Track. Sign Contracts.

Timestamp	Audit
March 18, 2020 3:48 pm PDT	Single-Family Residence Sewer Service Connection Request Uploaded by Colleen Johnson - [email protected] IP 64.98.26.37
March 19, 2020 8:31 am PDT	Laura Dallas - [email protected] added by Colleen Johnson - [email protected] as a CC'd Recipient Ip: 38.146.75.102
April 3, 2020 9:36 am PDT	Laura Dallas - [email protected] added by Colleen Johnson - [email protected] as a CC'd Recipient Ip: 38.146.75.102
April 3, 2020 9:37 am PDT	Laura Dallas - [email protected] added by Colleen Johnson - [email protected] as a CC'd Recipient Ip: 38.146.75.102
April 3, 2020 9:39 am PDT	Laura Dallas - [email protected] added by Colleen Johnson - [email protected] as a CC'd Recipient Ip: 38.146.75.102
May 9, 2020 1:06 pm PDT	Laura Dallas - [email protected] added by Colleen Johnson - [email protected] as a CC'd Recipient Ip: 38.146.75.120
October 21, 2020 10:50 am PDT	Laura Dallas - [email protected] added by Colleen Johnson - [email protected] as a CC'd Recipient Ip: 38.146.75.18
October 5, 2022 12:48 pm PDT	Laura Dallas - [email protected] added by Colleen Johnson - [email protected] as a CC'd Recipient Ip: 156.146.51.79
October 5, 2022 12:49 pm PDT	Laura Dallas - [email protected] added by Colleen Johnson - [email protected] as a CC'd Recipient Ip: 156.146.51.79
October 5, 2022 12:50 pm PDT	Laura Dallas - [email protected] added by Colleen Johnson - [email protected] as a CC'd Recipient Ip: 156.146.51.79
October 9, 2023 9:27 pm PDT	Laura Dallas - [email protected] added by Colleen Johnson - [email protected] as a CC'd Recipient Ip: 64.98.26.37

This audit trail report provides a detailed record of the online activity and events recorded for this document.

https://kootenaiponderaysewerdistrict.org/

Audit Trail Serial# f1e9bfcccb44c3add8ba86ee57d5b2b2