Sewer Application

Description

APPLlCATION FOR MUNICIPAL SEWER SERVICE to be provided by RIDGWAY TOWNSHIP MUNICIPAL AUTHORITY 1537B Montmorenci Rd., Ridgway, PA 15853 NOTE: The application must be complete in its entirety. Incomplete application packages will be returned to the applicant. Print or type all entries. The applicant agrees to be bound by all terms and conditions of the procedures for application and system rules and regulations established and accepted by the Ridgway Township Municipal Authority and Ridgway Township ordinances No. 64 & 68. No exceptions to the procedure shall be accepted without written consent of the Authority. The designated Municipal Authority representative will sign this form upon completion of the line construction inspection. 1. Name of Property owner(s):________________________________________________________ Address_______________________________________________________________ Ph #:___________________________ 2. Name of Applicant (if other than property owner)______________________________________ Address______________________________________________________________ Ph #___________________________________________________________________ 3. Type of Lot Use Proposed: ____Single Family Dwelling ____Two Family Dwelling Unit ____Multiple Use Units (Multiple Single family or multiple units per structure) ____Industrial (specify _______________________________________________________ ____Commercial (specify) ___________________________________________________ ____Other (specify) ________________________________________________________ 4. Schedule for Construction of Sewer Service: month______________ year__________________ Contractor’s Name________________________________________________________ Address___________________________________________________________________ Ph #______________________________________________________________________ (attach workers compensation form) 5. Sewer Service Tap Size (check) ____4”______6” _____larger (specify)______________________ (to be determined by Municipal Authority) All gravity Service lines and Connections shall be type PSM SDR 35 PVC pipe conforming to ASTM D3034 or equal. Pipe and fittings shall have bell and spigot type elastomeric gasketed joints. 6. Tap-In Fee Enclosed: Sewer Tap $2000 Check #______ or Online Payment at www.rtmawater.com Tap-In fee for Multiple Use, Commercial, Industrial, or other types of services may require separate computation guidelines to assess impact on existing facilities. 7.