Harveys Lake, PA · Luzerne County
Sewage Facilities Planning Module Application Mailer
This application mailer collects project and sewage-disposal details from a person proposing a development so the approving agency can determine planning requirements.
What this form is
Use this mailer to provide information about a proposed development and help determine whether sewage facilities planning is necessary and which forms apply. It asks for project and contact details, location, development size and use, sewage flows, and the planned disposal method; it also includes requests for planning exemptions. The instructions say to submit the completed mailer to the approving agency and provide a copy to the county health department.
Who needs it
A person proposing a development, or an authorized agent, uses the mailer to provide project information for sewage facilities planning review.
How to submit it
Submit the completed mailer to the approving agency, either the Department of Environmental Protection or a delegated local agency. Provide a copy to the county health department with jurisdiction over the project area.
About notarization
This document has no notary block; the applicant and other specified signers sign and date their sections, with no notarized or sworn attachment described.
How to submit this form
- 1
Download The Mailer
Download the Sewage Facilities Planning Module Application Mailer PDF.
- 2
Complete Project Details
Enter the proposed development, contact, location, size, sewage flow, and sewage-disposal information requested.
- 3
Gather Supporting Documents
If applicable, attach the plot plan, site reports, PNDI documentation, or facility-capacity documents described in the instructions.
- 4
Sign And Date
Have the applicant and any specified municipal official or sewage enforcement officer complete and sign their applicable sections.
- 5
Send The Mailer
Submit it to the approving agency and provide a copy to the county health department with jurisdiction over the project area.
Frequently asked questions
- What is the Sewage Facilities Planning Module Application Mailer?
- It collects information about a proposed development so the approving agency can determine whether sewage facilities planning is needed and which planning forms are appropriate.
- Who completes this application mailer?
- The person proposing the project or an authorized agent provides project, location, development, and sewage-disposal information. The form also has sections for specified municipal officials and a sewage enforcement officer.
- How do I submit the Sewage Facilities Planning Module Application Mailer?
- Send the completed mailer to the approving agency—the Department of Environmental Protection or a delegated local agency—and provide a copy to the county health department with jurisdiction over the project area.
- Do I need a notary for the Sewage Facilities Planning Module Application Mailer?
- No. The document has no notary block; the applicant and other specified signers sign and date their sections. It describes no notarized or sworn attachment.