Dutchess County, New YorkInstall / replacement permitReady to fill online

Residential Septic System Repair/Replacement As-Built

Step 2 form completed by the contractor after repair or replacement work is finished, documenting what was actually constructed and any deviations from the SAN-36A proposal, including an as-built sketch.

First page of the Dutchess County, New York Residential Septic System Repair/Replacement As-Built
Preview being prepared. The real form is what gets filled
Form
SAN-36B
Jurisdiction
Dutchess County, New York
Fields
25
Includes
Signatures
Fill and submit free

Create a free account to fill this form, sign it and download it ready to file. No card needed.

  • Your answers print onto the health department's own PDF
  • Sign on screen: phone, tablet or laptop
  • Save it and come back to it

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Type into the real county form. No printing, no retyping.

The county's own PDF

Your answers print onto the health department's document, not a lookalike.

Download and file

Get the finished PDF and hand it in exactly as they expect it.

What this form asks for

Have these to hand before you start.

  • Tax Map ID
  • Untitled field (undefined)
  • Untitled field (undefined_2)
  • Untitled field (undefined_3)
  • Untitled field (undefined_4)
  • Project Address
  • Name Of Property Owner
  • Owner Email Address
  • Owner Phone
  • Mailing Address
  • City State Zip
  • Name Of Contractor That Performed The Work
  • Mailing Address 2
  • City State Zip 2
  • Email Address
  • Phone
  • Fax
  • Describe Field Deviations From Part 1 Form And Provide Asbuilt Sketch On Reverse Side 1
  • Describe Field Deviations From Part 1 Form And Provide Asbuilt Sketch On Reverse Side 2
  • Describe Field Deviations From Part 1 Form And Provide Asbuilt Sketch On Reverse Side 3
  • Describe Field Deviations From Part 1 Form And Provide Asbuilt Sketch On Reverse Side 4
  • Date Repairreplacement Work Placed Into Operation
  • Distance Of Installed Wastewater Disposal System To Nearest Well
  • DBCH comments

…and 1 more.

Where it goes

Submit to DBCH upon completion of work; include as-built sketch with tie-in dimensions on reverse side.

Filed with ehs@dutchessny.gov.

The form is the free part

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Filling this permit is free and stays free. What you pay for is everything that happens around it: the filing, the chasing, the paperwork that piles up behind every install.

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  • 3 forms a month, filled and signed
  • The county's own PDF, not a lookalike
  • Site sketch and on-screen signatures
  • Saved for 6 months
  • Send to the property owner to sign
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