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Updated September 30, 2020 Page 1 of 1 CITY OF SALEM Engineering Department 98 Washington Street, 2nd floor Salem, MA 01970 Phone: (978) 619-5673 Kimberley Driscoll Mayor David H. Knowlton, P.E. City Engineer/DPS Director Checklist for Water & Sewer Tie cards Individual tie cards are required for each utility (domestic water service, fire service & sewer) Shall include size, material and length of each service from the main into the building Building shall be drawn to match the as-built condition of the building and identify the building’s address (proper shape) Shall include the install date, install by and date the ties were taken Shall include ties (distance) from at least 2 different points (corners of the building, poles, manhole structures, etc.) to the water shut off valves, sewer clean outs, bends in the sewer and to the connection at the City’s main for both water and sewer Shall identify the location of the shut off valve and any sewer clean outs or bends (sidewalk, street, etc) Shall include the size of the main and material if known David H. Knowlton, P.E. City Engineer/ DPW Director ***Disclaimers: 1. Every effort has been made to create a comprehensive list of requirements; however, the Engineering Department may require additional information or services not included in this checklist. 2. This document is subject to change at the City’s discretion. ---PAGE BREAK--- City of Salem, Massachusetts SERVICE ADDRESS WATER Service Card Install Date: Install By: Ties taken by: Street in which the main is located Water Main Curb Line Property Line North Arrow ---PAGE BREAK--- City of Salem, Massachusetts SERVICE ADDRESS SEWER Service Card Install Date: Install By: Ties taken by: Street in which the main is located Sewer Main Curb Line Property Line North Arrow