New Connection Application

Application for connection

To: Lewisburg Area Joint Sewer Authority

Lewisburg, Pennsylvania

Date(Required)

Residential or Commercial(Required)

Stories

It (is/will be) used as a(Required)

There (are/will be)(Required)

people living or working in the building

The building is located at(Required)

Borough of Lewisburg

East Buffalo Township

Buffalo Township

The source of water is(Required)

Name of general contractor(Required)

Name of contractor who will be responsible for sewer installation.(Required)

Owner(Required)

Contact Email(Required)

Contact Phone(Required)

Owner must Sign Print & Date. Print name exactly as it appears in the signature and enter the date of signature

Print Name(Required)

Date(Required)

Sign here(Required)

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