Putnam Valley, NY · Putnam County
Well Permit Application
Property owners or their agents use this application to request a well permit from the Town of Putnam Valley.
What this form is
This application requests a well permit and records information about the owner, property, proposed construction, estimated cost, and Putnam County well driller. The owner or agent agrees to follow applicable codes and regulations and provide temporary sanitary facilities until permanent facilities are operational. The form also includes space for inspector approval and lists a $75 well permit fee.
Who needs it
A property owner or agent seeking a well permit in the Town of Putnam Valley should complete this application.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details. The form lists a $75 well permit fee.
About notarization
This application is signed and dated without a notary; it also calls for a sanitary-facility receipt or owner acknowledgment, neither of which is identified as notarized.
How to submit this form
- 1
Download The Application
Download the Well Permit Application PDF.
- 2
Complete The Application
Enter the owner, property, construction, cost, and well driller information requested.
- 3
Gather Sanitary-Facility Information
Provide a portable sanitary-facility receipt or the owner's written acknowledgment that facilities are available in the existing structure.
- 4
Sign And Submit
Have the owner or agent sign and date the application, then submit it to the city department named on the form.
Frequently asked questions
- Do I need a notary for the Well Permit Application?
- No. The application calls for an owner or agent signature and date, not notarization. It also requests a sanitary-facility receipt or written owner acknowledgment, with no notarization stated.
- How do I submit the Well Permit Application?
- The form does not give submission instructions. Submit it to the city department named on the form and check the city website for current contact details. The listed permit fee is $75.
- What information does the application ask for?
- It asks for owner and property details, the nearest intersection, subdivision lot and zoning information, construction description and estimated cost, and the Putnam County well driller's name and license number.
Need something notarized?
This Well Permit Application doesn’t need a notary — but if you have another Putnam Valley form that does, a commissioned online notary can help.