Lyonsdale, NY · Lewis County
Septic System Permit Application
The Town of Lyonsdale application for property owners or authorized agents seeking approval to install or alter a septic system.
What this form is
Use this application to request a Town of Lyonsdale permit for septic system work; the form says the permit covers only the work described in the application. It asks for owner, contractor, project, and site details, plus a plot plan and engineered design. Applicants must also complete the applicable workers’ compensation statement, and the application includes a site diagram and environmental-concern statement.
Who needs it
Property owners or authorized agents applying to install or alter a septic system in the Town of Lyonsdale need this application.
How to submit it
The form lists a $50 fee and contact details for the enforcement officer and town clerk, but does not specify where or how to submit the application.
About notarization
This document is signed and dated without a notary; the homeowner’s workers’ compensation statement is made under penalty of perjury, but no notarization is specified.
How to submit this form
- 1
Download The Application
Download the Septic System Permit Application PDF.
- 2
Complete The Application
Fill in the owner, contractor, project, and site information, then sign and date the applicable statements.
- 3
Gather Required Attachments
Include one copy of a plot plan and two copies of the engineered design; contractors must include proof of compensation or exemption.
- 4
Contact The Town
Check the contact details listed on the form for submission instructions and the $50 fee.
Frequently asked questions
- Do I need a notary for the Septic System Permit Application?
- No. The application is signed and dated without a notary. Its homeowner workers’ compensation statement is made under penalty of perjury, but the document does not specify notarization.
- How do I submit the Septic System Permit Application?
- The form lists a $50 fee and contact details for the enforcement officer and town clerk, but does not give submission instructions.
- What must I include with the application?
- The form requires one copy of a plot plan and two copies of the engineered design. Contractor applicants must also provide proof of workers’ compensation coverage or exemption.
Need something notarized?
This Septic System Permit Application doesn’t need a notary — but if you have another Lyonsdale form that does, a commissioned online notary can help.