Apply by mail for a new on-site sewage disposal system installation

OSSD [Mail]
$150.00
To apply for this permit, enter the required information below and click "Next".

Select Application Type

 
Note: to recommend installation of holding tank, the installer must provide proof of lack of options available along with a letter stamped by an engineer stating there is no engineered solution available.

Type of Installation

 

Licensed installer information

 

Property Information

Yes
No

Property Owner Information

 

Property Owner's Address

 
PO Box

Building and sewage flow information

Yes
No
Yes
No
Yes
No

Select Disposal System Type

 
Distribution
 
Pressure Dosing
If pressure dosing of field is required, please specify dosing rate and volume per dose.
Yes
No
Elevation

Clearance Distances

 
Septic tank distance is equal or greater than
Yes
No
Not Applicable
Yes
No
Not Applicable
Yes
No
Not Applicable
Yes
No
Not Applicable
Yes
No
Not Applicable
Yes
No
Not Applicable
Disposal field distance is equal or greater than
Yes
No
Not Applicable
Yes
No
Not Applicable
Yes
No
Not Applicable
Yes
No
Not Applicable
Yes
No
Not Applicable
Yes
No
Not Applicable
Yes
No
Not Applicable
Yes
No
Not Applicable
Yes
No
Not Applicable

Original Soil Description

Test pit location must be shown on the plan drawing

 
Yes
No
or
)
or
From (ft)
To (ft)
Category

Attention System Owner

As per Section 16(2) and 18 of Regulation 2009-137, under the Public Health Act, it is requirement of the licensed installer to provide to the owner of an on-site sewage disposal system the following documents within ten (10) days after the system has been covered:
  • completed Certificate of Compliance
  • a copy of the plan of installation, (construction, repair or replacement)
  • the operating instructions for the system
Privacy Notice
Should you decide to provide all of the information requested on the form, it is important to know that its submission constitutes consent to the collection, use and disclosure of your personal information. Provision of the information requested is voluntary and you may, without prejudice, decline to respond which might prevent us from processing your request. The collection, use and disclosure of personal information is protected by the Right to Information and Protection of Privacy Act (RTIPPA), Personal Health Information Privacy and Access Act (PHIPAA) and all other applicable legislation, regulation or policy.
Department of Health Privacy Notice

Signature of Applicant

 
Checking this box is the same as providing your signature
Checking this box and electronically sending this form constitutes your electronic signature.
2025-12-16 [20251215.1 (119514)]