All mandatory fields denoted by an * must be filled in.
being the registered property owner(s) of the residential property located at:
I confirm the following as part of our request to participate in the RWSS program:
1) I am (one of) the legal owner(s) of the property and voluntarily wish to participate in the RWSS Service Connection Program.
2) The property is a residential property described as and as defined in the
Land Use Bylaw No. 99/059:*
*The Application Committee will review to confirm the description of the dwelling and will confirm the land zoning when considering the complete Application.
3) Concurrent with this Application, I am paying the application fee for the Service Connection of $200.00 (Two Hundred Dollars). I understand that there is a balance due for the
Service Connection Fee and elect to pay it as follows:
4) I understand that any unpaid portion of the Service Connection fee will be rolled over to the property tax bill for the subject property, including all applicable interest.
5) I will be responsible to hire a Certified Contractor to design and install the Service Connection to be located on my property. A list of Certified Contractors is available on the
Government of Alberta website, is maintained by Alberta Municipal Affairs and is called the “Private Sewage Systems Installer Certification List”.
6) I will be responsible to sign a contract to hire a Certified Contractor from the Private Sewage Systems Installer Certification List and to ensure that all fees pertaining to
design, permits, construction and warranties for the Service Connection are included within the contract with the Certified Contractor.
7) So long as I comply with the above requirements, I understand that the RMWB will pay the costs of the installation of the Service Connection(s) directly to the Certified
Contractor and the Owner(s) will pay the Service Connection Fee to the RMWB as described herein and in the Bylaw.
8) I further confirm that the RMWB is not liable for the Service Connection or the work performed by the Certified Contractor nor the future maintenance or repair costs for the
9) I understand that pursuant to the Bylaw, the Application Committee will consider my Application, when complete, to assess the qualification of the Owner(s) and eligibility
of the property for participation in the Funding Program and may reject quotes or proposed contracts with the Certified Contractor.
Billing Address (As it appears on your credit card)