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Application for a Sewer Connection Permit

  1. Laconia_city_logo_small

  2. City of Laconia

    Dept. of Public Works

  3. NOTE THAT QUESTIONS FOLLOWED BY AN ASTERISK * REQUIRE AN ANSWER IN ORDER TO SUBMIT YOUR APPLICATION

  4. (if different than Mailing Address)

  5. (the person responsible to connect with the sewer)

  6. (if different than contractor)

  7. building type: residence, motel, laundromat, trailer, . . .

  8. containing the following fixtures:

    (Type in the number of each type of fixture. If you skip an answer, it is considered zero.)

  9. I agree for myself, my heirs and assigns, to hold and save harmless, from any loss, cost damage or expense, happening by reason of any defect or blockage of said sanitary sewer, the street commissioner or the City of Laconia, NH.

  10. I further agree not to discharge into the sanitary sewer any surface water, cellar water or water from rain conductors as decreed by City Ordinance.

  11. 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.

  12. Your application cannot be approved until we receive payment in full. A permit costs $330, unless you are a first time user. A permit for a first time user costs $1,130. We cannot accept credit card payment online or over the phone at this time. Checks (written to the "City of Laconia") can be placed into the drop box at the south entrance of the DPW building during business hours (Mon-Fri 7:30am-4:00pm) or can be mailed to Laconia Department of Public Works, 27 Bisson Ave., Laconia, NH 03246.

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