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2. Sewer Lateral Disturbance & Abandonment Permit Application

   If an existing building is razed, or remodeled in any manner resulting in the disturbance of an existing sewer lateral, there must be a complete replacement of the existing lateral with a new PVC lateral entirely at the expense of the property owner. Exceptions are allowed if all processes and procedures are complied with below. Sewer lateral disturbance and abandonment requirements can be found under §232-8D of the Village Code.

   The Director of Public Works must approve all lateral procedures and possess video documentation prior to the submission to the Plan Commission for a Demolition Permit. Please label the video and supporting documents with: 

   • Owner’s name
   • Address
   • Phone number
   • Specified procedure 
   • Date
4. SUBMISSION REQUIREMENTS FOR SPECIFIED LATERAL PROCEDURES

   Replacement of existing lateral with new PVC

   • Submit videotape identifying the replacement with new PVC.
   • Signed approval by the Department of Public Works (this sheet). 

   Exceptions 

   Exceptions may be granted by the Director of Public Works if satisfactory evidence is submitted in a timely fashion demonstrating that the existing lateral is of PVC construction or the existing lateral has been lined.

   • Submit videotape indicating the existing lateral is entirely free from major defects.
   • Signed approval by the Department of Public Works (this sheet).

   Abandonment 

   In the event of abandonment, the lateral must be terminated at the main and permanently sealed at the main. Permanent seals and their inspections are the financial responsibility of the property owner. All sewer lateral abandonment work must be inspected and tested to the satisfaction of the Director of Public Works.

   • Submit videotape identifying the permanent seal.
   • Signed approval by the Department of Public Works (this sheet).

   Public Way Disturbance Permit

   Applicant must secure an approved Public Way Disturbance Permit from the Director of Public Works.

8. Name of Property Owner*
9. Address of Property*
11. Owner Phone Number*
12. Owner Email*
14. Contractor Name*
15. Contractor Address*
17. Contractor Phone Number*
18. Contractor Email*
20. Sewer Lateral Condition*

    1. Replacement of existing lateral with new PVC.
    2. Existing lateral free of defects.
    3. Existing lateral has been lined.
    4. Lateral terminated at the main and permanently sealed at the main.
22. Other Comments
24. Acknowledgement

    By submitting this form, you agree to adhere to the rules and regulations set forth by the Elm Grove municipal code. Failure to adhere to the municipal code may result in penalties. You further acknowledge the Village Staff may need to enter onto your property to inspect the final project and have granted them permission to inspect the project during and after completion. 

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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit Submit and Print

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