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Subsurface Wastewater Program Forms

Please click on the titles below to view our forms. You also may save the forms to your computer.

Please note that the HHE-200 Form, pages 1 through 3, are available both in AutoCAD and Adobe PDF formats.

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However, Auto Desk no longer supports this viewer. If you download and install it on your computer(s) you do so at your own risk. The Department of Health and Human Services neither assumes nor implies any responsibility for any adverse impacts or effects resulting from your use of Volo View Express.

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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, 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)


MS Word Files

Registration Form for Public Swimming Pools and Spas HHE-23

Replacement System Variance Request Form HHE-204 Form

First Time System Variance Request Form HHE-215 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

Holding Tank Application HHE-233 Form

Minimum Lot Size Law Waiver Application HHE-236

Statement of Rule Compliance HHE-238A

Request for Review of Onsite Subsurface Wastewater Disposal System Design HHE-614 (for Health Inspection Program licenses)

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.

HHE-200 Form, Page 1

HHE-200 Form, Page 2

HHE-200 Form, Page 2 with extra soil logs

HHE-200 Form, Page 3

Internal Plumbing Permit Application HHE-211

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

Well Setback Release Form HHE-306

MS Excel Files

Voluntary System Inspection Form HHE-240 Form

Water Use Records Percentile Calculator Spreadsheet