Author: Jamie Williams
Last saved by: tryon

TOWN OF TRYON
WATER/SEWER CONNECTION FORM

NAME: |
MAILING ADDRESS: |
SERVICE ADDRESS: |
WATER | | INSIDE TOWN |
SEWER | | OUTSIDE TOWN |

NAME OF PLUMBER |
NC LICENSE | | ZONING PERMIT# |
DATE OF UTILITY SERVICE NEEDED |

WATER TAP FEE |
| ¾” Inside | $1200.00 | ¾” Outside | $1900.00
| 1” Inside | $1890.00 | 1” Outside | $2500.00
| 2” Inside | $2400.00 | 2” Outside | $3500.00
SEWER TAP FEE |
| Inside | $900.00 | Outside | $1700.00
LAKE LANIER IMPACT FEE | | WATER EXTENSION |
$2500.00

METER CHARGE |
| ¾” - $275.00 | 1” - $375.00 | 2” - $1100.00

DEPOSIT | | |
TOTAL | | |
DATE PAID | | |
I HEREBY APPLY FOR UTILITY SERVICE AS STATED ABOVE AND AGREE TO ABIDE BY THE TOWN ORDINANCE GOVERNING SUCH SERVICE.

________________________________________________________________
                                                      SIGNATURE

TOWN USE:
BOOK | | STOP | | SERIAL # |
METER SIZE | | | | TRANSMITTER # |
DATE TAP SET | | | | COMPLETED BY |
PSI | | (If 23 psi or less – tap will be abandoned and money refunded unless customer signs written agreement stating they are aware of low psi and that they will be responsible for installing a booster pump.