Preventing Illness and Promoting Wellness for Communities in Eastern Connecticut

  • Andover
  • Ashford
  • Bolton
  • Chaplin
  • Columbia
  • Coventry
  • Mansfield
  • Scotland
  • Tolland
  • Willington

The following forms are in PDF format. Can't open the forms? You may need to install or upgrade Adobe Acrobat - Download Acrobat here

FEE SCHEDULE EFFECTIVE JULY 1, 2016

Septic Systems and Plan Reviews

  • Application for Plan Review - needed when submitting plans for review of new septic system designs, repair system plans, alterations and septic tank replacements.  See the fee schedule for the appropriate fee to accompany this plan.  
  • Staking Verification Memo for Engineer Designed Systems
  • Instructions for Non-Engineered Systems
  • Proposed Design Information Worksheet for Non-Engineered Systems
  • Application for Soil Testing - needed when submitting plans for new property development, subdivision, septic system repair, B100a soil testing and for future repairs at time of property sales.
  • B100a Application - for building conversion, change of use, building addition, accessory structure and lot line change.
  • Septic System Application - Application for Permit to Construct or Repair a Sewage Disposal System; submitted after an Application for Plan Review and the accompanying fee (see above). 
  • Septic System As-Built Plan - needed when permitted installation is completed and approved. An accurate as-built helps homeowners find the septic tank and leaching field components for easier maintenance and care of the system.

    Food Service

    Other Forms or Applications 

  • Campground Registration Form
  • Daycare or Group Home Inspection Application
  • Tick Submittal Form
  • Health or Code Violation Complaint Form