NWWA: Lateral Maintenance Sign Up

I hereby make application for the Lateral Maintenance Program in accordance with the plan description.

Please do not send a payment; charge will be applied to water invoice.

Fees:

Residential: $10.00 per year
Commercial: 3/4" and 1" connection $18.00 per year
Commercial: 1-1/2" and 2" connection $30.00 per year

To apply by mail, follow these steps:
Step 1: Print out this page with the Lateral Maintenance Plan Application on it.
Step 2: Complete the application
Step 3: Mail the completed form to:

NWWA
Attn: Lateral Maintenance
PO Box 1339
200 W. Walnut Street
North Wales, PA 19454-0339

OR drop off the completed application at our office.

Customer name:
Street:
City:
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Email: