Form — Water/Sewer Application - Salish and Kootenai Housing Authority

Water/Sewer Application

Step 1 of 5

Cover Letter*
I/we acknowledge that I/we reviewed, and agree to the Water/Sewer Cover Letter.*

IHS Participant Service Agreement
I understand fully the below statements:*
- It is extremely important to have all water/sewer hook-ups staked and visible for our crews. Failure to have these service connection locates clearly marked may delay the completion of your construction project.
- If SKHA – Operations arrive on your project to find that the locations are not clearly marked, the construction crew may move to the next participant on the construction schedule to ensure that we don’t experience delays and cost overruns to our budget waiting for these locations to be marked. You will be rescheduled for services at our earliest convenience.
- Both water and sewer hook-ups need to be stubbed 5 feet from the house. Please make sure your plumber is aware of this. We want the installation of your services to go as smoothly and quickly as possible.
- It is also important for you to know that we do not provide landscaping for the area where your services have been installed. We will however, rough in the area by cleaning up and leveling. We might also put down some type of grass seed to avoid any erosion. Any other type of improvements will be provided by you, the participant.
- This installation of water and/or sewer services is your one time service provision under Indian Health Service assistance. This installation is warranted for one year after construction is completed. Anything after the one year warranty period will be the homeowner’s responsibility to do maintenance and repairs as needed.
Participant’s Signature*
Date*
MM slash DD slash YYYY

Water/Sewer Application

Water/Sewer Application

Step 1 of 5

PARTICIPANTS CHECKLIST FOR SERVICES — Please read, check all boxes and sign.

We will leave your property as clean as possible, but we do not prepare it for landscaping.

ASSISTANCE REQUESTED:

PRIOR ASSISTANCE

INFORMATION REGARDING HOME

SITE INFORMATION

PHYSICAL ADDRESS

LAND STATUS

WATER RIGHTS QUESTIONS

Lawn & Garden

Irrigation

Other

IHS Participant Service Agreement

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