Sterling, NY · Cayuga County
Septic System Variance Request Form
Property owners use this form to ask the Cayuga County Health Department to waive or extend specified septic system inspections or pump-out requirements.
What this form is
This form requests a variance from the Cayuga County Health Department for a property transfer inspection, routine inspection, or septic tank pump-out. The applicant checks the requested waiver or extension and explains the reasons for the request. It asks for property and contact information, relevant buyer, owner, or seller details, and signatures; incomplete or unsigned requests will be returned.
Who needs it
Property owners or parties involved in a property transfer can use this form to request a listed septic inspection or pump-out waiver or extension.
How to submit it
Submit the completed form to the Cayuga County Health Department, Environmental Division, at 8 Dill Street, Auburn, NY 13021.
About notarization
This form is signed and dated without a notary; it mentions no notarized or sworn attachment, so the required signers simply sign.
How to submit this form
- 1
Download The Form
Download the Septic System Variance Request Form.
- 2
Complete The Request
Enter the property and contact details, select the requested waiver or extension, and explain the reasons.
- 3
Gather Attachments
The form does not list any required attachments.
- 4
Sign And Submit
Have the applicable parties sign, then submit the completed form to the Cayuga County Health Department, Environmental Division, in Auburn.
Frequently asked questions
- Do I need a notary for the Septic System Variance Request Form?
- No. This form is signed and dated without a notary, and it does not mention a notarized or sworn attachment.
- How do I submit the Septic System Variance Request Form?
- Complete and sign the form, then submit it to the Cayuga County Health Department, Environmental Division, at 8 Dill Street, Auburn, NY 13021.
- What can I request with this form?
- You can request that the Health Department waive or extend a property transfer inspection, routine inspection, or septic tank pump-out.
- What information does the form ask for?
- It asks for the tax map number, town, property address, whether the property borders Owasco Lake or Little Sodus Bay, reasons for the request, contact details, and applicable signatures.
Need something notarized?
This Septic System Variance Request Form doesn’t need a notary — but if you have another Sterling form that does, a commissioned online notary can help.