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Water / Wastewater Connection Application

  1. Town Seal Transparent Background 2k x 2k


  2. TOWN OF MILTON
    WATER & WASTEWATER DIVISION
    PHONE - 802-893-6030
    EMAIL - telwood@miltonvt.gov

  3. WATER & WASTEWATER CONNECTION APPLICATION

  4. Applicant Contact Information

  5. Engineer/Consultant Contact Information

  6. Project Information

  7. What type of project is this?*
  8. Please provide a brief overview of the project.

  9. (Gallons per Day)

  10. (Gallons per Day)

  11. Please provide the following information for your project:

  12. Residential
  13. Number of Bedrooms

  14. Number of bedrooms

  15. Number of bedrooms

  16. Commercial
  17. Design flow gallons per day

  18. Design flow gallons per day

  19. Design flow gallons per day

  20. Public Infrastructure
  21. Design flow gallons per day

  22. Other items to be submitted with this application:

  23. Please attach a site plan for the proposed project, to include connection details.

  24. 3. Completed & signed applicable fee schedule

    Must be completed and signed by Engineer/Consultant

  25. Fillable fee schedule can be found HERE.

    (Please note, forms not complete on Google Chrome may not auto populate correctly)

  26. Fillable fee schedule can be found HERE.

    (Please note, forms not complete on Google Chrome may not auto populate correctly)

  27. Fillable fee schedule can be found HERE.

    (Please note, forms not complete on Google Chrome may not auto populate correctly)

  28. 4. Application Fee
  29. Application payments may be submitted in on of the following ways:

    Online Payment (Please not there is a 3% service fee charged for any debit/credit card transactions) 

    Pay Online Here

    Mail a check to the Municipal Office at 43 Bombardier Road, Milton, VT 05468 (All checks made out to "Town of Milton").

    Pay in person with cash, check or card at the Municipal Office.

  30. Applicant Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  31. Leave This Blank:

  32. This field is not part of the form submission.