Cost notification FORM CVWD-699C - 2023-12-07COACHELLA VALLEY WATER DISTRICT
COST NOTIFICATION APPLICATION
CVWD Form 699-C
Rev. (5/12)
Applicant Information
Project Description:
Project Information
Legal Description
Name:
Mailing Address:
(Street)
(City) (State) (Zip)
Contact person:
(Telephone)
Project:
Owner:
Project address: (Street) (City)
If tenant improvement, name of business and type of business:
Section Township Range Parcel Map No./Tract No:
Lot No(s):
Assessor's Parcel No(s):
COACHELLA VALLEY WATER DISTRICT
COST NOTIFICATION APPLICATION
CVWD Form 699-C
Rev. (5/12)
Type of Development
Domestic Water
New _____ Remodel _____ Restaurant _____ Office _____ School _____ Warehouse ____
Clubhouse _____ Retail _____ Residential _____ Other ______________________________
Single floor? _____ or Multi-floor? _____ Elevator? Yes _____ No _____
Sewer discharge? Yes _____ No _____ Cooling Tower? Yes _____ No_____
Water System Backup Facilities Charge (WSBFC) :
(Complete all items.)
1. Fire flow requirement: gallons-per-minute (Attach letter from fire marshal)
2. Building square footage: square feet
3. Site square footage: square feet
4. Street frontage: lineal feet
Water Meters/Water Service
(Domestic Meters)
1. Are meters existing? Yes ______ No ______ If yes, how many ______
2. New meter request (size and quantity) ¾" ______, 1" ______, 1½" ______, 2" ______
(Landscape Meters)
1. New meter request (size and quantity) ¾" ______, 1" ______, 1½" ______, 2" ______
2. Meter size approved by CVWD Water Management Department Yes_____ No _____
COACHELLA VALLEY WATER DISTRICT
COST NOTIFICATION APPLICATION
CVWD Form 699-C
Rev. (5/12)
Domestic Water
Sanitation
Sanitation Capacity Charge (SCC) -Complete only the applicable items
Facilities To Be Constructed By CVWD
1. Fire hydrant: How many? ______
2. Fire detector check: How many? ______ Size ___________
3. Relocations: Yes _____ No _____ If yes, describe in detail: _________________________
_____________________________________________________________________________
_____________________________________________________________________________
Retail:
How many employees? ______ How many suites? ______
How many restrooms? ______
Warehouse or Office:
How many suites? ______ How many restrooms? ______
COACHELLA VALLEY WATER DISTRICT
COST NOTIFICATION APPLICATION
CVWD Form 699-C
Rev. (5/12)
Sanitation
Sanitation Capacity Charge (SCC) - Complete only the applicable items
School:
How many students? Is there a cafeteria? Yes _____ No _____
Grease Interceptor required? Yes _____ No _____
CVWD approved grease interceptor? Yes ______ No ______
If yes, approved size _____________________________
If no, provide a single sheet isometric drawing and equipment schedule of all the fixtures
discharging into Grease/Sand and/or Oil Interceptor/Separator.
Clubhouse:
How many restrooms? ______
How many fixtures? ______ (Such as toilets, showers, sinks and urinals.)
Kitchen in clubhouse, complete restaurant portion.
Restaurant:
(total number of seating)
Bar with food service _____ Are there outside misters or heaters? Yes _____ No
Bar with nonfood service _____
Dining inside seating _____ Dining outside seating _____
Grease Interceptor required? Yes _____ No _____
CVWD approved grease interceptor? Yes ______ No ______
If yes, approved size _____________________________
If no, provide a single sheet isometric drawing and equipment schedule of all the fixtures
discharging into Grease/Sand and/or Oil Interceptor/Separator.
COACHELLA VALLEY WATER DISTRICT
COST NOTIFICATION APPLICATION
CVWD Form 699-C
Rev. (5/12)
Sanitation
Sanitation Capacity Charge (SCC) - Complete only the applicable items
Mechanical Repair Facility:
How many restrooms _____
Floor drains routed to sewer? Yes ______ No ______
Sand/Oil Separator required? Yes _____ No _____
CVWD approved sand/oil separator? Yes ______ No ______
If yes, approved size _____________________________
If no, provide a single sheet isometric drawing and equipment schedule of all the fixtures
discharging into Grease/Sand and/or Oil Interceptor/Separator.
Carwash:
How many restrooms _____
Floor drains routed to sewer? Yes ______ No ______
Number of cars washed per day? ______
Gallons of water used per car? ______
Sand/Oil Separator required? Yes _____ No _____
CVWD approved sand/oil separator? Yes ______ No ______
If yes, approved size _____________________________
If no, provide a single sheet isometric drawing and equipment schedule of all the fixtures
discharging into Grease/Sand and/or Oil Interceptor/Separator.
COACHELLA VALLEY WATER DISTRICT
COST NOTIFICATION APPLICATION
CVWD Form 699-C
Rev. (5/12)
Sanitation
Sanitation
Submitted by: Date:
PROVIDE ONE SET OF PLANS WITH APPLICATION.
Facilities To Be Constructed By CVWD
1. Sanitation house lateral: How many? ______ Size ______
2. Relocations: Yes ______ No ______ If yes, describe in detail: ______________________
_____________________________________________________________________________
_____________________________________________________________________________