APPENDIX A: FORM OF SEWER TAP PERMIT
Sewer Tap Permit for Residential, Commercial or Industrial Users
Name of Resident or Business ________________________________________________
Address ________________________________________________
Date of Application_____/___________/______________
Purposed Date of Connection ________/__________/__________
Tap for Residents: ________ Commercial: ____________ Industrial: ____________
1.    Distance from Building to Sewer ____ (Ft)
2.    Name of Street or Location of Alley Where Tap is to Be Made ________________________
3.    Distance from Tap to Nearest Manhole _____ (Ft)
4.    Name of Person(s) or Contractor Making Tap _______________________________________
   Note: A Drawing Showing the Information Listed on Lines 1, 2, and 3 Must Accompany This Application.
Inspection Date: _____/______/______      Inspection Passed: YES   NO
Reason for Failing Inspection: __________________________________________________________
___________________________________________________________________________________
Date to Be Reinspected: _____/______/ ________
   Note: A $20.00 Reinspection Fee will Be Charged for Every Additional Inspection.
Sewer Tap Permit for Residential, Commercial or Industrial Users.
Sewer Tap Fees are Based on Water Meter Size (Circle One)
Meter Size Tap Fee   Tap Fee
5/8-inch-3/4-inch................................................$350.00
1-inch.................................................................$560.00
1-1/4-inch...........................................................$700.00
1-1/2-inch...........................................................$840.00
2-inch..............................................................$1,120.00
3-inch..............................................................$1,680.00
4-inch..............................................................$2,240.00
Enter Amount of Tap Fee $______
Enter Amount of Inspection Fee $______
(Residential and Commercial Inspection Fee $25.00 Industrial Inspection Fee are $50.00)
Enter Total Amount $____
Tap Fee Collected By: ____________________________________________
Permit Approved by (W.W.T.P.)_____Date_____/______/________
Water Works Superintendent_____________   Date______ /______/_________
Reinspection Fee $_____      Collected By: __________________________
In Consideration of the Granting of this Permit I, the Undersigned Agree:
(Sign)______________________      Date_____/_____/________
   (A)   TO ACCEPT AND ABIDE BY ALL PROVISIONS of THE CITY of LIGONIER ORDINANCE NO. 539, AND ALL OTHER PERTINENT ORDINANCES OR REGULATIONS THAT MAY BE ADOPTED IN THE FUTURE.
   (B)   TO INSTALL AND MAINTAIN THE BUILDING SEWER AT NO EXPENSE TO THE CITY OF LIGONIER.
   (C)   TO NOTIFY THE SUPERINTENDENT WHEN THE BUILDING SEWER IS READY for INSPECTION AND CONNECTION TO THE PUBLIC SEWER, BUT BEFORE ANY PORTION OF THE WORK IS COVERED.
(1998 Code, § 9-105)