SEWER DYE TEST APPLICATION

MUNICIPAL AUTHORITY OF WASHINGTON TOWNSHIP

APPLICATION FOR DYE TESTING
** Note the applicant is required to schedule the dye test within three (3) days of submitting the application by calling the authority at 724.929.3370. The authority has 15 days to complete the inspection. **

DYE TEST ORDINANCE O-01-19

Effective 3-13-19

If you prefer to download a printable Sewer Dye Test application, click here.

This Credit Deposit Application for Sewer Dye Testing is subject to the Rules and Regulations established by the Municipal Authority of Washington Township. A deposit in the amount of One Hundred Dollars ($125.00 ) is required with this application, payable via check or money order to MAWT or pay online after submission of this form.

Any other text here?

Property Owner Name

Property Street Address

Tax Map No.

Water/Sewer Account No. (if known)

Seller's Realtor

Agency

Daytime Phone#

Fax#

Reason for Request

Sale Refinance Other

Other reason

Name of Purchaser (If Sale)

Closing Date

Closing Company

Contact Person Name

Contact Person Address, City, St Zip

Daytime Phone# of Contact Person

Fax# of Contact Person

I Accept

I hereby acknowledge that the above information is correct and that I agree to use the sewer according to the Rules and Regulations of the Authority, and to pay for sewer service at the above service location.

TYPE YOUR NAME HERE

date

ANY OTHER INFO you would like to tell us?

(Jan, I'm not sure if you need the Billing Area, Account No, Date Issued, Date of Scheduled Inspection, Water On: yes/no. We'll need to discuss)

IMPORTANT: When you click the SEND button below, you will be taken to our secure payment page. If you want to pay online, choose the SECURITY DEPOSIT drop-down and follow the instructions for payment.

PLEASE BE SURE TO INCLUDE YOUR ACCOUNT NUMBER OR SERVICE ADDRESS IN THE REFERENCE FIELD WHEN PROCESSING YOUR PAYMENT.

** BE AWARE OF PROCESSING FEE– YOU WILL BE ABLE TO SEE THE FEE BEFORE ALLOWING PAYMENT TO PROCESS — As of October 1, 2016 the convenience fee is 2.65%. The minimum fee is $3.00.

***DO NOT USE ANY DASHES, SLASHES OR PERIODS IN THE EXPIRATION DATE, CARD NUMBER OR PHONE NUMBER– IT WILL NOT ACCEPT IF YOU DO.

E-Check is also a payment option–this service is a flat $1.50 service fee — please be aware—E-checks are not resubmitted– should the funds not be available the first time it is presented– it will not be reprocessed and you will incur a NSF charge from both MuniciPay and the Authority.

If you prefer to pay via check or money order, you can drop a check or money order off at our office or mail to:
Municipal Authority of Washington Township
1390 Fayette Ave
Belle Vernon PA 15012