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Permission to become Tenant TOWN OF WAPPINGER TOWN CLERK Christine Fulton SUPERVISOR Barbara A. Gutzler 20 MIDDLEBUSH ROAD WAPPINGERS FALLS, NY 12590 WWW.TOWNOFWAPPINGER.US (845) 297-4158 - Main (845) 297 -5771 - Direct (845) 298-1478 - Fax TOWN BOARD William H. Beale Vincent Bettina Ismay Czamiecki Michael Kuzmicz Office of the Town Clerk Re: Permission to become Tenant To: Dear: The Town of Wappinger has granted you permission to make a water/sewer connection to the District / Improvement Area at (address), due to the extreme urgency and nature of your problem. The permission is given to connect as a tenant to the subject to the following conditions: 1. The connection is to be made at your expense and subject to inspection by the Town Building Inspector or his designee; 2. A connection fee of $500 must be paid, via certified check, prior to connection to the water / sewer line; 3. A Road Opening Permit must be obtained from the Highway Department, a $50.00 fee paid, and a $500.00 Road Opening Bond posted in the form of a certified check made out to the Town of Wappinger. The Bond will be returned if the road is restored to the satisfaction of the Highway Superintendent. 4. If and when a Water / Sewer District or Water / Sewer Improvement Area is formed which would include your property, you agree to become part of said District or Improvement Area and hereby waive any objection to its formation; 5. This permission will expire upon your failure to: a. accept in writing the terms and conditions contained in this letter within 90 days hereof; b. obtain a building permit and / or connect to the water / sewer system within one year from the date hereof; 6. The terms and conditions of this permission shall be binding on and inure to the benefit of the undersigned, and any subsequent owners of the subject premises, subject to the rules and regulations adopted by the Town Board ofthe Town of Wappinger for use of water / sewer improvements / districts by tenant users, as the same may be amended from time to time. This letter will be effective upon the Town's receipt of your agreement to all conditions, as set forth above and acknowledged by the countersignatures of all owners of the property on the enclosed copy ofthis letter, which will serve as an acknowledgement of your acceptance. Yours truly, Christine Fulton Town Clerk Town of Wappinger Date of Acceptance: Owner Owner This document is to be returned to the Town Clerk