Onsite Wastewater Construction Permit
Please see instruction and complete form below.
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Property Serial Number
*
Property Address of Waste Water Site
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Applicant Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
example@example.com
Are you the current property owner?
*
Please Select
YES
NO
System Designer Name
*
First Name
Last Name
Click Link to view complete list of
Waste Water Contractors and Installers
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
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System Installer
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
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Homeowner install?
*
Please Select
YES
No
Drinking Water Source
*
Well/Spring
Public Water Connection
Upload the following
Proof of water rights for well or spring or a "will serve letter" for a Public Water Connection
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Detailed System Design (see page #2)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Plot plan
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Official floor plan of each level of the building
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Current Tax ID form.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Signature
*
Waste Water System
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( X )
Conventional System
$
540.00
Quantity
1
2
3
4
5
6
7
8
9
10
Deep Trench or Absorption bed system
$
640.00
Quantity
1
2
3
4
5
6
7
8
9
10
Alternative System
$
740.00
Quantity
1
2
3
4
5
6
7
8
9
10
Property/homeowner training install fee
If home owner wishes to install their own Waste Water System, a training class is required to learn how to correctly install system.
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card
Submit
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