Onondaga County, NY · Onondaga County
Residential On-Site Water Supply Specific Waiver Application
Property owners use this application to request a waiver for a new or replacement residential well that cannot meet one or more water supply standards.
At a glance
- Issued by
- City of Onondaga County · Onondaga County, Onondaga County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- onondaga.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 to consider a waiver for a new or replacement residential well that does not meet one or more standards for water wells. The property owner provides site information, reasons for noncompliance, proposed protective measures, and supporting documents; a professional engineer or registered well driller also signs. The waiver must be obtained before drilling a well that does not meet standards.
Who needs it
A property owner proposing a noncompliant new or replacement residential well needs this application, with a professional engineer or eligible registered well driller’s signature.
How to submit it
Submit the application and supporting information to the local Health Department having jurisdiction; the form does not provide an address, email, or portal.
About notarization
This document is signed and dated by the applicant and design professional or well driller without a notary; the form identifies no notarized or sworn attachment.
How to submit this form
- 1
Download the Application
Download the residential water supply specific waiver application.
- 2
Complete the Application
Provide the applicant and site information, reasons for noncompliance, and proposed protective measures or site conditions.
- 3
Gather Supporting Information
Include supporting materials such as a detailed site plan, hydrogeologic and site evaluation details, and water test report.
- 4
Sign and Submit
Have the applicant and design professional or well driller sign and date the application, then submit it to the local Health Department having jurisdiction.
Frequently asked questions
- Do I need a notary for the Residential On-Site Water Supply Specific Waiver Application?
- No. The applicant and design professional or well driller sign and date the application; the form does not identify any notarized or sworn attachment.
- Who uses this water supply waiver application?
- A property owner uses it to request a waiver for a new or replacement residential well that cannot meet one or more standards. A professional engineer or, for some replacement wells, a registered well driller also signs.
- What supporting information does the application request?
- The form requests supporting information such as a detailed site plan, hydrogeologic and site evaluation details, a water test report, and other information supporting the waiver request.
- How do I submit the water supply waiver application?
- Submit the application and supporting information to the local Health Department having jurisdiction. The form does not list an address, email, or online submission portal.