Cayuga County, NY · Cayuga County
Specific Waiver Application for Residential On-Site Wastewater Treatment Systems
Property owners and their engineers use this application to request a waiver when a proposed residential on-site wastewater treatment system cannot meet applicable standards.
At a glance
- Issued by
- City of Cayuga County · Cayuga County, Cayuga County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- cayugacounty.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This application asks the Health Department with jurisdiction to consider a waiver for a residential on-site wastewater treatment system that cannot meet one or more standards. A specific waiver must be obtained before construction. The form requests applicant and property information, reasons for noncompliance, a description of the proposed design and mitigating measures, supporting site information, and signatures from the owner and a professional engineer or registered architect.
Who needs it
Property owners seeking a waiver for a noncompliant residential wastewater system complete the application with an engineer’s supporting design information.
How to submit it
Submit the application to the Health Department having jurisdiction, which reviews the request and may ask for additional information.
About notarization
This document is signed and dated without a notary; the applicant and professional engineer or registered architect provide their signatures and dates.
How to submit this form
- 1
Download the Application
Download the specific waiver application for residential on-site wastewater treatment systems.
- 2
Complete the Application
Provide applicant and property information, identify reasons the proposed design cannot meet standards, and describe the proposed design and mitigation.
- 3
Gather Supporting Information
Include detailed design and site information, such as a site plan and soil and site evaluation, as appropriate.
- 4
Sign and Submit
Have the applicant and professional engineer or registered architect sign and date the application, then submit it to the Health Department having jurisdiction.
Frequently asked questions
- Do I need a notary for the wastewater waiver application?
- No. The applicant and professional engineer or registered architect sign and date the application; it does not require a notary.
- How do I submit the specific waiver application?
- Submit it to the Health Department having jurisdiction. The Health Department reviews the request and may ask for additional information.
- What supporting information does the application request?
- The application asks for a description of the proposed design and mitigating measures. Supporting materials may include detailed design plans, a site plan, and soil and site evaluation information.