HomeMy WebLinkAboutCommercial Plan Review_Utility Extension Review - signed CFPUA Engineering Department
235 Government Center Drive
Wilmington, NC 28403 ~ 910-332-6560
LOG-IN DATE STAMP CFPUA USE ONLY
APPROVED: _______________________________
DENIED: __________________________________
REVISIONS: _______________________________
REVIEW FEE RECEIVED:
$__________________
REVIEW FEES
Utility Extension
(Total Water and Sewer
Main Footage)
Review
Fee
0 – 500 Linear Feet $240
500 – 999 Linear Feet $300
1,000 – 4,999 Linear Feet $600
5,000 – 9,999 Linear Feet $850
10,000 and up Linear Feet $1,400
Re-Review Fee $50
Application For:
Commercial Plan Review and/or Utility Extension Review with Listing of CFPUA Fees
NOTE: Submittals must include an Application, two (2) sets of plans with vicinity map, and Plan Review Fee.
Date Received: ________________________________________ CFPUA File #: __________________________________________
Project Manager: _______________________________________ NHC Building Permit #: __________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Please type or print:
1) NAME OF DEVELOPMENT: ____________________________________________________________________________________
2) ADDRESS OF DEVELOPMENT: _________________________________________________________________________________
3) TYPE OF DEVELOPMENT / USE(S): ______________________________________________________________________________
4) NUMBER OF UNITS: __________, WATER DEMAND IN GPD: ______________, SEWER DEMAND IN GPD: ______________
5) TAX I.D. NUMBER: ____________________________________________________________________________________________
6) PRESENT ZONING: ______________ PROPOSED ZONING CHANGES: ______________ ACRES: ________________________
7) IS A WATER: MAIN PROPOSED: YES: _________ NO: _________ , SERVICE PROPOSED: YES: _________ NO: _________
8) IS A SEWER: MAIN PROPOSED: YES: _________ NO: _________, SERVICE PROPOSED: YES: _________, NO: ________
9) IS THERE AN EXISTING: SEWER TAP? YES: ________ NO: ________ , WATER SERVICE: YES: _________, NO: ________
(If there is an existing sewer tap, a Work Order must be sent to Operations to camera existing cleanout)
10) IS A FIRE LINE PROPOSED: YES: _________, NO: _________
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ OWNER / DEVELOPER: _____________________________________________________________________________________
ADDRESS: _____________________________________________________________________________________
CONTACT PERSON: ______________________________________________________________________________________
PHONE #: _______________________________________, FAX #: _____________________________________
E-MAIL ADDRESS: _____________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PLANS PREPARED BY: _____________________________________________________________________________________
ADDRESS: _____________________________________________________________________________________
CONTACT PERSON: ______________________________________________________________________________________
PHONE #: _______________________________________, FAX #: _____________________________________
E-MAIL ADDRESS: _____________________________________________________________________________________
_____________________________________________________________________ ___________________________
SIGNATURE OF OWNER / DEVELOPER / REPRESENTATIVE DATE
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Pump Station Review $350
Minor Subdivision (5 lots or less;
with no utility extension)
$120
Commercial Plan Review
(Taps Only)
$120
5/9/23