New Water Connection Application - Northern Ireland Water services... · Please make your...

Valid from 1st April 2018 of 6

* completion is mandatory

Form Reference: WC-A079-SD

1. Applicant’s DetailsNote: The named applicant in this section will be contacted by NI Water

Company Name

Contact Name

Address

Town Daytime Tel

County Mobile

Postcode Email

Fax

Standard Industrial Classification Code (SIC Code) (If Applicable)

2. Connection location

Property/ Plot No.

Road/Street or Development Name Town/ City County Postcode Is this the final postal address

No. of Storeys

Continue over if required

New Water Connection Application (up to 32mm)Article 79 - Water and Sewerage Services (Northern Ireland) Order 2006

Please note - this form can be used to apply for new or replacement water connections up to 32 mm in external diameter provided each separately occupied unit or property is situated on the same development, road or street and will place the same demand on the NI Water Infrastructure, as per section 6a. Please complete separate applications if this is not the case. - this is not an application for a new water main to service a housing development. If a new water main is required to facilitate the connection, please complete application WRI-A076 ’Application for a Watermain Requisition Internal to a Site’. You MUST submit this application a minimum of 3 months prior to the mains being required on site to allow adequate time for the digital submission to be processed and design completed. - applications for new water connections internal to housing developments will not be approved until the new watermain layout has been designed and the necessary drawings issued.

Please complete all relevant sections of this form clearly and in BLOCK CAPITALS.

Please make your application for a new Sewer Connection at the same time as this New Water Connection if required.

Failure to complete all mandatory sections may result in the delay / return of your application.

Please refer to our guidance notes before completing your application.

Will the applicant be the future occupier of the property upon completion? Yes No

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Property/ Plot No.

Road/Street or Development Name Town/ City County Postcode Is this the final postal address

No. of Storeys

Additional table will be accepted if each separately occupied unit or property is located on the same development, road or street and will place the same demand on the NI Water Infrastructure. Please print out page 2 as appropriate.

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3. Purpose of supply & property status once the connection has been made Please state the number of units by type that will be served by the new connection(s)

New Property Existing Conversion Replacement

Domestic

Agricultural

Church / Community Hall

Club or Public House

Fire Fighting Supply

Hotel / Guest House

Hospital / Nursing Home

Industrial

School

Sports Facilities

Other

For’ Industrial’ or’ Other’, please provide specific details as to what the intended use of the supply will be

Charity Purposes - if the property or properties are to be used by a registered charity, please provide the registered charity

number – the charity must be the primary occupant of the premises.

Listed Buildings (Please provide customs and excise certificate number if applying for zero VAT rating as an approved alteration

to a listed building)

Note on Cross Border Supplies; if you are applying for a supply to serve a property in the Republic of Ireland from NI Water’s network, the application must be made on behalf of the applicant by Irish Water. All bills will be invoiced to Irish Water.

4. Building Water SupplyIs a new supply of public water required for building purposes? (Please tick appropriate box) Yes No

Is it intended to use an existing metered public water supply? (Please tick the appropriate box) Yes No

If yes, please provide metered customer reference number, dates of construction and the address from which the building

supply will be provided.

If a customer does not require a building supply then this must be stated and the reasons why. The charge is levied to take

account of unmeasured water used during the course of construction. Please note that once paid, the building supply is

non-refundable.

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5. How will you discharge foul Sewage from the property/properties? Public Sewer (Please complete form ‘New Sewer Connection Application’ SC-A163 if the site is to remain private with the sewers not being offered to NI Water for consideration for adoption under Article 161 of the Water and Sewerage Services (NI) Order 2006).

Septic Tank Private Sewer Temporary Treatment Works

No foul sewage

6a. Infrastructure Charges (Non-domestic properties only)All new water connections are subject to a one off water, and where applicable, sewerage infrastructure charge. In some cases infrastructure charge credits may be applicable. In order to calculate the charge, please complete the following table.

Appliances Number per unit / property

Loadingunits

Load (office use only)

Existing Proposed Existing Proposed

WC Flushing cistern 2

Wash basin in a house 1.5

Wash basin elsewhere 3

Bath (tap size 20mm)

10

Bath (tap size >20mm)

22

Shower 3

Sink (tap size 15mm)

3

Sink (tap size >15mm)

5

Spray Tap 0.5

Bidet 1.5

Communal / commercial appliance 10

Any other water fitting or outlet (including a tap but excluding a urinal or water softener)

3

Official Use OnlyTotal load

Extra Loading Units

No. of Infrastructure Charges

Existing Services

6b. Infrastructure Charge Credits (to be completed by all applicants)In some cases infrastructure charge credits may be applicable. This will be the case if there was a previous supply to the site

which has been disconnected in the last 5 years. It is the customer’s responsibility to provide us with the information to

determine if any credits are applicable. If the information is not provided, then normal charges will apply.

Has the site being developed had a water supply within the last 5 years? Yes No

If yes, please state the type of property previously on this site (e.g. house, factory, etc.)

Please state the total number of separate water supplies connected to the watermain previously on site:

Approximate date of disconnection (if applicable):

Total number of separate water supplies to be connected to the public water main in the new development:

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7. Removal of Existing Metered Supplies (if applicable)If the new supply or supplies are intended to replace an existing metered supply;

Are there existing metered connections on the site? Yes No

If yes, please provide the customer reference number

Is the new connection; in addition to the existing connection (s) Or, a replacement for the existing connection(s)

If the new connection is a replacement for the existing connection, is the existing metered connection to be removed;

On the same date as the new connection is installed Or, is it to be removed at a later date

Please note that it is the duty of the applicant to advise NI Water if they require the removal of an existing meter. Failure to do so may result in the continuation of charges for a meter if it is not removed.

8. Size of Connection RequiredPlease select the size of your supply pipe

External diameter: 25mm 32mm

A Standing Charge is levied on all metered non-domestic customers, the scale of the charge is related to the internal diameter of the customer’s supply pipe as per the current Scheme of Charges – www.niwater.com/servicesfordevelopers.asp

9. Street Works LicenceUnder the Street Works (NI) Order 1995 a Street Works Licence is required by any person or organisation who wishes to place or

retain apparatus in a street.

● NI Water is an approved Utility Contractor and CAN carry out the full service connection.

● NI Water, under the prescribed charges, will make the connection to the watermain, fit an external stopcock, a

meter guardbox (if appropriate) and lay the associated underground service pipe.

Where will the proposed connection be completed? Adopted Road / Street

Unadopted Road / Street

Private Road / Street

● Where the connection is located within an Adopted Road / Street the excavation and reinstatement MUST be completed by

NI Water, the cost of this service will be included in the quotation.● Where the connection is located in an Unadopted or Private Road / Street the developer MAY carry out the excavation and

reinstatement.

10. Planning Service Details/ Building Control Details (if applicable)Planning Application Ref Date of Approval Please attach a copy of the Planning Approval

Building Control Ref Date of Approval

Type of Site Green Field Brown Field

If Brown Field what was previous use

11. Water RegulationsHave Planning Service placed any conditions on site due to contaminated ground Yes NoIf ‘Yes’, please provide details of the restrictions

Please note that where planning permission is required, NI Water will not process your application until we have been provided with a copy of the full planning permission.

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11. Water Regulations (cont)If there will be water within your site not supplied by NI Water, please specify

Borewell Spring Water Rain Water Harvesting

Other (Please specify)

12. DeclarationI now apply to NI Water for a supply of water to the location(s) detailed in section 2. I accept responsibility for a one-off

infrastructure charge, as well as charges payable for the connection(s) to which this application relates. Details of NI Water charges can be found on the current Scheme of Charges at www.niwater.com/servicesfordevelopers.asp.

Please tick to indicate that you have read and understood each point;

I/We agree to pay the water & sewerage Infrastructure Charge(s), if applicable, at the same time as the water connection charge.

I/We undertake to agree to abide by the terms and conditions of the Water Supply (Water Fittings) Regulations (NI) 2009.

I/We understand that any alterations made to this application must be declared to NI Water.

I/We have filled in all of the relevant sections of this form. The details I/we have given in this application are accurate.

I/We have read and understood the supporting guidance notes.

I/We understand and accept that as the named applicant that I/we will be responsible for any metered bills generated in relation to these connections from the time of connection. It will be my/our responsibility to ensure that the correct customer billing information is provided to Northern Ireland Water in respect of each of the metered accounts which are to be created as a result of this application. Currently all non-domestic customers are billed for the volume of water used via the installation of a NI Water meter. This meter will be installed shortly after the time of connection.

I/We understand that where the final postal address has not been provided, I/we as the applicant will be responsible for

providing NI Water with the final postal address(es) as soon as it/they have been confirmed.

Before submitting your application please ensure that you have completed all relevant sections and the requirements below have been included.

Site Location Plan 1:1250 / 1:2500 map (LPS ACE map will suffice) with the preferred connection point and site boundary clearly indicated in red and relative to an existing feature. Any other land owned by the applicant should be shown with a blue line around its boundaries, and if a public right of way exists within or adjoining the site, it should be outlined in green.

a copy of the Planning Approval (if applicable). This must be provided with all applications relating to newly built or refurbished properties or any property where an alteration has been made.

Site Plan if application is for multiple units

Street Works Licence (if applicable)

Name (in BLOCK capitals)

Signed

Date

Please return the completed application form to: Northern Ireland Water Customer Connections Team P.O. Box 1039 Ballymena BT42 9BN

Tel: 03457 440088 Email: [email protected]

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