††† WEST MIFFLIN SANITARY SEWER MUNICIPAL AUTHORITY

www.wmssma.org

 

††† 1302 Lower Bull Run Road†† West Mifflin, PA 15122-2902

Phone: (412) 466-6070††††† Fax: (412) 466-8108

 

 

SEWER TAP-IN PERMIT APPLICATION

For Customers EXEMPT from Tap-in-Fees (Sewer extension projects funded by certain types of state or federal grants)

 

PROPERTY LOCATION

††††††††††††††††††††† ††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††Street Address

 

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PROPERTY OWNER††††††††††

 

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††††††††††††††† †††††††††††††††††††††††††††††††††††††††††††††††__†††††††††††††††††††††††††††††††††††††††††††††††††† ††††††††††††† Street Address

 

 

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CONTRACTOR††††††

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Type of Building Construction††††††††††††††††††††††††††††††††††††††††††††† ††††_ Single Family Residence

††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† ††††††† Multi Family Residence

††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† ††††††† Commercial

††††††††††††††††††††††††††††††† ††††††††††††††† ††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† ††††††† Industrial

 

Number of EDUís (effluent discharge unit) ††††††_ (For three or more EDUís an approved Planning Module must be submitted with the application.)

 (1 EDU = 226 gallons per day).

Is a sewer extension necessary to serve this development?†††††††††††††††††† Yes/No

If yes, then two sets of design drawings prepared by a registered professional engineer or surveyor must be submitted with this application. If no, then submit a sketch of how the private lateral will connect to the public sewer.

 

Does the public sewer abut your property?†††††††††††††††††††††††††††††††††††††††††† Yes/No

 

I certify that the information provided above is true and correct to the best of my knowledge.

 

Signature of Applicant

 

 

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