<%@ Language=VBScript %> Application

OLDHAM COUNTY SEWER DISTRICT
APPLICATION FOR REVIEW OF PRELIMINARY DEVELOPMENT PLANS
(Service for systems used to collect, pump, transport or treat wastwater)

Project      
 

Name

  

Location
Description      
       
Owner      
 

Name

  

Address
       
       
 

Owner's Signature                                                           Date

  

Telephone No.

CHECKLIST FOR SUBMITTAL DOCUMENTS

Applicant to check each item

 1.        _____  2 copies of preliminary subdivision plan, engineering reports and/or related documents.

 2.        _____  U.S.G.S. map showing project location and boundary or service area as applicable.

 3.        _____  Letter from Oldham County Health Department if on-site sewage disposal systems are proposed.

 4.        _____  Approval letter from private treatment plan owner and entity who will own, operate, and maintain the system.

 5.        _____  Letter from Oldham County Soil and Conservation District..
 

Design Engineer      
 

Name

  

Registration No.
       
 

Telephone No.

    
     

Address

 Application Fee To Be Paid


Amount Due

  
r Preliminary Development or Subdivision Plan   $   250

Note: Fee is nonrefundable. Make check payable to: “Oldham County Sewer District.” Incomplete submittals will be returned with no review.
 

For OCSD Use Only

Date Plans Received:

WWTP:
No. Received:     Plans     Specifications:      
Other Material:                  
Reviewing Engineer:            

Date Payment Received:

    
Comments:            

Amount Received:

    
             

Received By:

    


700 W Jefferson Street
 LaGrange, KY  40031
Phone:  502-225-9477        Fax:  (502) 225-9468        email:  mail@oldhamcountysewer.com