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Home My WebLink AboutApplication - PSDS PermitRevised 2020-02-19 Date Received:______________ PRIVATE SEWAGE DISPOSAL SYSTEM PERMIT APPLICATION FORM   Owner / Applicant: _____________________________________________________ Contractor: Project Location: Submit with Application:  Please Provide a Detailed Description of Work: *** NOTE THAT WORK MUST BE INSPECTED BEFORE COVERING *** TYPE OF WORK INSTALLATION TREATMENT DISPOSAL METHODS Commercial/Conventional New Complete all applicable items: Industrial/Conventional Alteration Septic Tank Size: Serial No.: Residential/Conventional Expected Volume of Effluent: Holding Tank Size: Serial No.: Commercial/Advanced m³/day Treatment Mound Size: (sand layer)  ft² m² Industrial/Advanced Litres/day Disposal Field Size: (trench bottom)  ft² m² Residential/ Advanced Gallons/day Depth of Water Table: Feet  Inches Work Camp/No. of Men: (not to exceed 25 m³   FOIPP Notification:section 63 of the Safety Codes Act. It will be used for processing permit applications, issuing permits, safety codes compliathe Homeowner Declaration: By signing this application I Private Sewage Installer’s Certification No.: PS Permit Fee: $ SCC Levy: Issuing Officer’s Name: Total Cost: $ ($4.50 or 4% of the permit fee maximum $560.00  183037 Range Road 145 P.O. Box 130 Brooks, AB T1R 1B2 Phone: 403-362-3266 | www.countyofnewell.ab.ca