Full Text
For King County Use Only Account # No. of RCEs Rate Residential Sewer Use Certification Sewage Treatment Capacity Charge To be completed for all new sewer connections, reconnections, or change of use of existing connections. Please Print or Type (to be filled out by owner/representative) Department of Natural Resources and Parks Wastewater Treatment Division 2404_13540R_WTD_RevAcoRecPro_CapChargeForm2_V1 (Rev. 04/24) Please report any demolitions of pre-existing structures on this property. Credit for a demolition may be given under some circumstances. (See King County Code 28.84.050, O.5) Demolition of pre-existing structure? Yes No Was structure on sanitary sewer? Yes No Was sewer connected before 2/1/90? Yes No Sewer disconnect date: Type of structure(s) demolished: Address of Demolition/Capping Permit Number: Are multiple structures replacing the demolished structure? Yes No Please check appropriate box: Residential Customer Equivalent (RCE) Single-family (free standing, detached only) Property Street Address City State ZIP Owner’s Name Party To Be Billed (if different than owner) Mailing Address City State ZIP Owner’s Phone Number/email address Property Contact Phone Number/email address To be filled out by Sewer District Sewer District Sewer or Building Permit Final Date Side Sewer or Building Permit Number Required: Property Tax Parcel Number Subdivision Name Subdivision Number Lot Number Block Number Building Name Pursuant to King County Code 28.84.050, all sewer customers who establish a new service which uses metropolitan sewage facilities shall be subject to a capacity charge. The amount of the charge is established annually by the Metropolitan King County Council at a rate per month, per residential customer or residential customer equivalent, for a period of fifteen years. The purpose of the charge is to recover costs of providing sewage treatment capacity for new sewer customers. All future billings can be prepaid at a discounted amount. Questions regarding the capacity charge or this form should be referred to King County Wastewater Treatment Division at [PHONE REDACTED]. I understand that the information given is correct. I understand that the capacity charge levied will be based on this information. I understand that any deviation may result in a revised capacity charge. Signature of Owner/Representative Date Print Name of Net square footage less than 1,500 Square Feet 0.81 Net square footage 3,000 Square Feet or greater 1.16 3-Plex (0.81 RCE per unit) 2.43 Net square footage 1,500 to 2,999 Square Feet 1.0 Duplex or any Single-Family + ADU (0.81 RCE per unit) 1.62 Detached accessory dwelling unit (DADU) 0.59 4-Plex (0.81 RCE per unit) 3.24 Other: 5 or more (0.63 RCE per unit) No. of Units x 0.63 = If yes, will the capacity charge be paid by the Homeowner’s Association? Yes No If Multi-family, will units be sold individually? Yes No Mobile home space (1.0 RCE per space) No. of Spaces x 1.0 = Attached accessory dwelling unit (ADU) 0.59 No. of Units x = Live/work (work portion - please fill out a non-residential form) Microhousing No. of Units x 0.35 = Low-income No. of Units x 0.32 = SIGN