Winston-Salem, NC · Forsyth County
Affidavit of On-Site Wastewater Existing System
This affidavit is for property owners applying for a building permit exemption who must affirm that proposed construction meets local and state wastewater system setback requirements.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
This affidavit records a property owner's sworn statement that proposed building construction will meet local and state on-site wastewater system setback requirements and will not increase the existing system's design daily flow or wastewater strength. The form is required with a permit application when the applicant seeks the exemption identified on the form. The owner may consult a qualified wastewater evaluator or inspector before signing.
Who needs it
A property owner applying for a building permit exemption under the provision named on the form must complete and submit this affidavit with the permit application.
How to get this notarized
- 1
Download the Affidavit
Get the Affidavit of On-Site Wastewater Existing System from the City of Winston-Salem.
- 2
Fill In the Form
Enter the property and parcel information and the property owner's full name; leave the notary section for the notarial act.
- 3
Book an Online Notary
Check available notarization options for your situation and book a commissioned online notary if eligible.
- 4
Sign Before the Notary
Follow the notary's instructions to swear or affirm and sign the affidavit.
- 5
Submit With Your Application
Include the notarized affidavit with the permit application seeking the stated exemption.
Preview the form
The blank PDF straight from Winston-Salem. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I get this affidavit notarized?
- Complete the form, then check which notarization options are available for your situation before booking a commissioned online notary. Sign only as directed during the notarial act.
- Do I need a notary for this affidavit?
- Yes. The form includes a jurat requiring the property owner to swear or affirm and sign before a notary.
- Can I use remote online notarization in North Carolina?
- North Carolina's remote electronic notarization program has not launched. Emergency video notarization is different and requires the signer and notary to be inside North Carolina.
- When is this affidavit required?
- The form says it is required with a permit application when the applicant seeks the exemption identified on the form. Confirm with the city or town if unsure.