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2. Instructions and Definitions

   1. This application is for residential development only. 2. All services will be pending until a field inspection is completed. If a field inspection failed; the customer is required to pay the difference for the service. All services will be inspected by the City once installed. 3. Customer must make sure that the address is clearly marked on the lot, and viewable from the road. 4. The following definitions are used in this application: a. Service Available: The infrastructure has been completed and accepted. Distribution Main is a new water/wastewater main that must be extended. The water distribution/wastewater collection main is located in the street and may provide service, but there is no service line to the property. A copy of Inspection Sheet from the City Utility Inspector must be submitted prior to release of water/wastewater request. No approval for building permit will be allowed without a completed Meter Application from the Utility Division. b. Well/Septic Permit Required: City Water/Wastewater is not available now or in the near future. Applicant should pursue a Domestic Well (for water) or a Liquid Waste Disposal System (for sewer and approved by NMED). A Domestic Well application must be submitted. It is available on the City website at: https://rrnm.gov/2215/Domestic-Well-Program.  All items are submitted online.  A septic tank is allowed but the septic permit must come from NMED and be submitted with the well packet.. c. Pro-Rata: If a pro-rata is due for water and wastewater then it must be paid along with impact fees.

6. Applicant Information
8. Name:*
9. Mailing Address:*
11. E-mail:*
12. Phone:
13. Fax:
17. Legal Description of Property
19. Subdivision*
20. Unit:*
21. Block:*
22. Lot:*
24. Physical Address:*
25. Is the Road Paved?*

    1. Yes
    2. No
29. Acknowledgement and Signature
    I certify that the information in this application is truthful and correct to the best of my knowledge.
31. Applicant Signature:*
32. Date:*
    Date:
36. FOR DEPARTMENT USE ONLY
38. Water
39. Wastewater
41. ____ Service Line Available
42. ____ Service Line Available
44. ____ Service Line Not Available
45. ____ Service Line Not Available
47. ____ Distribution Service Main Available
48. ____ Distribution Service Main Available
50. ____ Distribution Service Main Not Available
51. ____ Distribution Service Main Not Available

53. ____ Rio Rancho City Well Permit Required

54. ____ Septic Permit Required
58. Pro-Rata payment due?
59. Payment Amount
61. ____ Yes
63. Water
64. $ ____________________
66. ____ No
68. Sewer
69. $ ____________________
72. Total
73. $ ____________________
77. Approved By:
    ___________________________________________
80. Date:
    __________________
Leave This Blank:


82. Submit Submit and Print

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