Teton Village Water & Sewer District
Fiscal Year 25-26 Connection Application for Residential Customers office@tetonvillagewy.gov • 7020 N Rachel Way • PO Box 586 • Teton Village, WY 83025
Instructions: Please complete all sections of this application to document the building’s plumbing fixture units (FUs) and either the equivalent residential units (ERUs) or the average peak occupancy (APO) at the end of the project. Remodel projects need a second application form to provide the same information from before the remodel so the District can credit previously authorized FUs, ERUs or APOs. If there are any questions, please call the District office at (307) 733-5457.
Please deliver the following to the District office at least one week prior to a regular Board Meeting:
1. The completed Connection Application(s).
2. A set of plans showing the location and type of all plumbing fixtures.
3. A site plan or sketch showing the location of all service lines, water meters and backflow preventers. When the District approves the Connection Application, you will be notified of the Connection Fee due. Approved connection fees & a nonrefundable review fee of two hundred fifty ($250) dollars will be billed via the properties monthly water and sewer bill. **Adjustments to final fixture count and connection cost, approved on this application, may be made to reflect significant changes generated during construction. The Connection Permit is issued when the Connection Application is approved & the Connection Fee is paid. All water use must be metered, and all meters must be supplied by the District. If you need a meter, please complete a Water Meter Purchase Agreement, available from the District office. All work must be done in accordance with the Teton Village Water & Sewer District Rules & Regulations. All District maps are approximate. Ensure actual utility locations are marked by the appropriate utility.
OWNER INFORMATION
Printed Name:
Billing Address: (City) (State) (Zip)
Phone #: Email:
APPLICANT INFORMATION (If other than owner)
Printed Name:
Mailing Address: (City) (State) (Zip)
Phone #: Email:
PROJECT INFORMATION
Description: Street Address: Lot
one):
Contractor’s Name:
Plumber’s Name:
CONNECTION FEE CALCULATION
These connection fees are valid for applications submitted to the District from July 1, 2025, to June 30, 2026.
The Connection Fee is your pro-rated share, based on fixture units, of the value of the District’s assets, net of depreciation and debt, which will be used to provide your water and sewer services. The fees are based on the District’s most current audited financial statements.
Water connection fee = water fixture units (page 4) _____________ X $88.56/fixture unit = $ _______
Sewer connection fee = sewer fixture units (page 4) ______________ X $89.70/fixture unit = $
Total Connection Fee = (water connection fee plus sewer connection fee) = $ Do not pay the connection fee until the application has been approved by TVW&SD.
CERTIFICATION
I certify that all information in this application, and that is included as part of this application, is correct
Signature:
Printed Name:
Date:
Received By: Date
Approver’s Printed Name: Date:
Approver’s Signature: Pre-backfill Service Line Bedding & Connection Inspection Approval
Approver’s Printed Name: Date:
Approver’s Signature: Post-backfill Service Line Leak & Pressure Testing & Inspection Approval
Approver’s Printed Name: Date:
Approver’s Signature:
Approver’s Printed Name: Date:
Approver’s Signature:
List all plumbing fixtures connected to the water system. Schedule B fixtures must not drain into the sewer. There are no fixture units assigned for fire protection or suppression uses.
Schedule A Plumbing Fixture Types (May drain into the sewer)
bathroom fixtures
(call the District for guidance at 307-733-5457)
List all fixtures connected to the District’s water system. Schedule B fixtures must not drain into the sewer.
Schedule B Plumbing Fixture Types (Must NOT drain into the sewer)
(call the District for guidance at 307-733-5457)
Calculate water and sewer fixture units.
Water fixture units = (Schedule A total fixture units plus Schedule B total fixture units) =
Sewer fixture units = Schedule A total fixture units =
Applicant must provide the following information to assist in the District’s peak capacity planning. This information does not impact your fees or payments.
Residential projects for any single-family residence, single family accessory residential unit, condominium, townhouse or apartment on any lot within the District must provide the following equivalent residential unit (ERU) information. If there are any questions, please call the District office at (307) 733-5457.