HomeMy WebLinkAboutDNR - Paradise Estates SANITARY Sewage Treatment Agreement - 9.5.2023DocuSign Envelope ID: ECE3C9EC-61B7-49FB-94C2-8623B1342A58
Iowa Department of Natural Resources
Wastewater Section
Construction Permit Application
Sewage Treatment Agreement
INSTRUCTIONS
This agreement must be executed for all projects where construction and sewage treatment will be provided by different parties;
i.e., a private subdivision connecting to a municipal system. This agreement must be executed by the parties who are owners at the
time the permit is issued, regardless of whether title to the proposed construction project will be transferred after completion of the
project.
This agreement is not necessary when a contract for sewage treatment already exists; i.e., service contracts between municipalities.
However, the Department of Natural Resources must be informed in writing that the contractual agreement does exist.
APPLICANT
Owner: CJ's Construction, Inc.
ENGINEER
Firm: YTT Design Solutions
Address: 2915 Dubuque St NE, Iowa City, Iowa 52240
Address: 3500 Ctr Pt Rd NE, Ste3, Cedar Rapids, IA 52402
Representative: Cory Hodapp, Owner
Project Officer: Lisa S. Burch, P.E.
Phone Number: 319-631-3149
Phone Number: 319-210-0422
Project Identification:
Owner and System Receiving
Paradise Estates First Addition Residential Subdivision Phase 1
Wastes: City of Waterloo
I am the authorized
constructed in accordance
treatment system id
Signature
CERTIFICATION
representative of the owner identified above and state that the proposed sanitary sewage facilities shall be
with the plans and specifications and all wastes contributed by this project shall be discharged to the
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AGREEMENT TO PROVIDE SEWAGE TREATMENT
I am the authorized representative of the owner of the system identified above and state that the connection of the proposed
sanitary sewage facilities identified above is approved by the owner, and that the owner accepts responsibility for providing
adequate treatment of all wastes contributed by this project, in accordance with the provisions of Chapter 455B, Code of Iowa, and
the rules of the Department of Natural Resources. This agreement shall not be construed in any way to affect any local ordinances,
sewer service agreements, or fee systems entered into between the parties.
Name: Quentin Hart Title: Mayor
SIbNI�I, 9/5/2023
Signature marl U'-1 " rL" Date Phone:
9/2018 cmc
DNR Form 542-3219; 29