Subsurface Wastewater Team Forms

AutoCAD Files | TurboCAD Files | MS Word Files | Adobe PDF Files | MS Excel Files


Elimination of Permit Labels for Forms

With input from Local Plumbing Inspectors and Site Evaluators, the Subsurface Wastewater Team eliminated the permit labels or "stickers" that we have issued for decades. Local Plumbing Inspectors affixed the labels to the upper right hand corner of the HHE-200 (subsurface wastewater application) and HHE-211 (internal plumbing application) forms and filled in the required information.

As of August 1, 2011, we no longer issue permit labels to municipalities, however, one still needs to provide the information which has been written on the label the label is now just part of the form. In the right hand corner of the revised HHE-200 and HHE-211 forms we have replicated the information that would have been included on a permit label. The only real change is that LPIs will now need to fill in the town name and permit number.

We suggest that LPIs simply continue with the current numbering system in use. For example, if the last permit label completed was #1,200, the first "fill in" permit number would be #1,201. Complete the rest of the permit label information as usual. LPIs may find it helpful to keep a ledger, spreadsheet, or database for recordkeeping purposes. A simple spreadsheet is available.

If an LPI receives an application on a prior version of the forms, dated prior to August 1, 2011 the LPI may use any remaining stickers or place a blank label in the permit label area and add the relevant information. We do not anticipate that there will be a large number of older applications.

Top of Page


Please note that the HHE-200 Form, pages 1 through 3, are available in AutoCAD, TurboCAD, and Adobe PDF formats. You will need to have either a CAD compatible program to view our CAD files, or you will need a viewer.

PC users may download a copy of Autodesk DWG TrueView from their web site. There are many shareware viewers available as well.

Apple users can find free demonstration downloads at these sites. The Division makes no representation whatsoever for Apple products compatiblity.

TurboCAD Macintosh   VersaCAD Mac

Linux users can also find open source software for manipulating AutoCAD files. For example, LX-Viewer is a program that will allow you to open, view, print and convert DWG or DXF files. This program has not been evaluated by the Division of Environmental Health, and no representation as to its efficacy is implied or stated.


AutoCAD Files

Subsurface Wastewater Disposal System Application
HHE-200 Form, page 1

Subsurface Wastewater Disposal System Application
HHE-200 Form, page 2 (grid)

Subsurface Wastewater Disposal System Application
HHE-200 Form, page 2 (no grid)

Subsurface Wastewater Disposal System Application
HHE-200 Form 2 with extra soil logs

Subsurface Wastewater Disposal System Application
HHE-200 Form, page 3 (grid)

Subsurface Wastewater Disposal System Application
HHE-200 Form, page 3 (no grid)

Top of Page

TurboCAD Files

Subsurface Wastewater Disposal System Application
HHE-200 Form, page 1

Subsurface Wastewater Disposal System Application
HHE-200 Form, page 2 (grid)

Subsurface Wastewater Disposal System Application
HHE-200 Form, page 2 (no grid)

Subsurface Wastewater Disposal System Application
HHE-200 Form, Page 2 with extra soil logs

Subsurface Wastewater Disposal System Application
HHE-200 Form, page 3 (grid)

Subsurface Wastewater Disposal System Application
HHE-200 Form, page 3 (no grid)

Top of Page

MS Word Files

Notice of Permit for use when a suburface wastewater system permit is issued.

Variance Request Form HHE-204 Form

Internal Plumbing Permit Application HHE-211

Personal Reference Form for S.E. Exam HHE-217 Form

Application for Engineered Onsite Sewage Disposal System HHE-220 Form

Statement of Compliance for Engineered Systems HHE-220a Form

Product Registration HHE-221 Form (doc file)

Holding Tank Application HHE-233 Form

Minimum Lot Size Waiver HHE-236 Form

Notice of Intent to Install a Subsurface Wastewater Disposal System...Expanded Structure HHE-234

Notice of Intent to Install a Subsurface Wastewater Disposal System...Replacement System HHE-234A

Notice of Intent to Install a Subsurface Wastewater Disposal System in the Shoreland Zone HHE-234B

Notice of Intent to Install a Subsurface Wastewater Disposal System Outside the Shoreland Zone HHE-234-C

Minimum Lot Size Law Waiver Application HHE-236

Statement of Rule Compliance HHE-238A

Affidavit of Site Preparation HHE-238B

Certificates of Approval HHE-239

Top of Page

Adobe PDF Files

These files require that you have a copy of Adobe Acrobat Reader to view and print them. Download a free Acrobat Reader.

Inspection Checklist for LPIs

HHE-200 Form, Page 1

HHE-200 Form, Page 1 (fillable PDF version). You may fill out the form online and print directly from your web browser or Adobe Reader, or save it to your computer. This form is optimized for Adobe Reader X. To toggle field highlights in Adobe Reader X for printing, click on "Highlight Existing Fields" in the upper right corner of the screen.

HHE-200 Form, Page 2

HHE-200 Form, Page 2 (no grid)

HHE-200 Form, Page 2 with extra soil logs

HHE-200 Form, Page 3

HHE-200 Form, Page 3 (no grid)

Variance Request Form HHE-204 Form

Internal Plumbing Permit Application, HHE-211 Form

Product Registration HHE-221 Form

MS Excel Files

Voluntary Septic System Inspection Form (Each tab in the spreadsheet comprises one page of the report.)

Water Use Records Percentile Calculator Spreadsheet

Top of Page