Last Name *
Application Type
Property Serviced By *
FOR NEW CONSTRUCTION, PLEASE CONTACT THE HEALTH DEPARTMENT
Important Info
First Name *
Application Type *
Owner Email *
Applicant Details
Email *
ALTERATION [$175.00] means any change in the physical configuration of an existing individual subsurface sewage disposal system or any of its component parts, such that there will be a change in the location, design, construction, size, capacity, type of, or number of one or more components. A permit to alter requires site evaluation and soil testing to be observed by the Administrative Authority. The alteration shall be made in conformance with plans and specifications prepared by a licensed New Jersey professional engineer and in conformance with N.J.A.C. 7:9A. Two (2) design copies signed and sealed by a professional engineer must be submitted separately.

REPAIR [$75.00] means to fix, refurbish or replace one or more components of an individual subsurface sewage disposal system in a manner that will restore and preserve the original location, design, and construction of the system. A sketch of the location and size of all the existing septic system components and a detailed description of how the repair will be done must be included.
Is Property Within The Wetlands or Wetlands Buffer Area? *
# of Bedrooms *
Address 2
ZIP *
{[PNAME]}
Phone Number *
100 Community Drive
Skillman, New Jersey 08558
Phone: 908-359-8211 Fax: 908-533-9336
Email: Health@montgomerynj.gov
Is Property Part of the Septic Management District? *
Address *
City *
State *
  • Installer
  • Sketch of Repair
  • Septic System
  • Certification
Phone Number *
Installer Details
Email *
Description of Alteration/Repair *
System Installer *
Sketch of Repair
Please draw a detailed sketch of all system components and attach it here.
Size of Pump Tank (if applicable)
The Septic System Serves:
Year of Installation
Year of Repair
Type of Business
Size of Septic Tank (in Gallons)
# of Employees
Has a previous repair been done?
System Type
Type Full Name :
Sign With Hand
Certification
The installer agrees to install the sewage disposal system in accordance with the approved design and all applicable state and local codes. I understand that no deviations from the design will be allowed without specific prior approval of the Administrative Authority & the design engineer.
The fee for this application is:
Application Fee
Signature *
(If the property is not part of the Septic Tank Management District) - I hereby apply for a license to operate, use, and maintain an on-site subsurface wastewater disposal system to serve the below designated property located within Montgomery Township. I certify that to the best of my knowledge, the information being furnished is true and correct.
By signing below, I the applicant certify that all of the information provided in this application is true and accurate.
The property owner hereby recognizes that the issuance of a permit by the Administrative Authority to alter or repair the above specified system shall not be construed or relied upon as a guarantee that the system, as repaired or altered, will function satisfactorily, nor shall it in any way restrict the powers or responsibilities of the Administrative Authority in the enforcement of any law or ordinance relating to public health. Henceforth, the property owner further understands the septic system shall be subject to the provisions of the Montgomery Township Board of Health Septic Management Code.