City of St. Marys, PA
Street Department
11 LAFAYETTE STREET ST. MARYS PENNSYLVANIA 15857
PHONE (814) 781-1718 www.stmaryspa.gov FAX (814) 834-1304
SURFACE DRAINAGE PERMIT
CHAPTER 21, PART 3
APPLICANT __________________________________________________________
ADDRESS ____________________________________________________________
INSTALLATION SITE ____________________________________________________
TELEPHONE NUMBER __________________________________________________
TYPE OF INSTALLATION ________________________________________________
LENGTH OF AREA TO BE SEWERED IN ____________________________________
___________________________________________ ____ ________________
Signature Date
PERMIT
SPECIAL INSTRUCTIONS ________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
____________________________________________ ___________________
Street Superintendent Date
“A PENNSYLVANIA ONE CALL IS REQUIRED PRIOR TO DIGGING.”
---------------------------------------------------------------------------------------------------------------------
FEES: Under 24’ in length - $20.00
Over 24’ in length - $35.00 (may include catch basin(s)).
NOTE: Applicant/Property Owner is responsible for all expenses, proper installation, notifications, and
maintenance.
Drainage.per
4-20
click to sign
signature
click to edit