Construction Permit Application Form, Wastewater Works (Appendix A)
This information is provided by the Nebraska Department of Environmental Quality  
to assist the public and regulated community .

Form #:  WAT133
Applications and Forms
Revised: 3/1/08
SizeFile Name
86 KB Appendix A form.pdf


Above is the construction permit application form for wastewater works, including those operated by: Municipalities, Sanitary Improvement Districts, Commercial or Industrial Wastewater Facilities, and Private Developments.

Note: Effective Oct. 1, 2009, any individual submitting any application or form that would derive public benefit from the state must also fill out a United States Citizenship Attestation form. This applies to individuals submitting the forms on their own behalf. If applicable, please fill out the United States Citizenship Attestation form below and submit it with the relevant applications and forms.

United States Citizenship Attestation Form

This Complete Form is only available as an Adobe Acrobat (PDF) file.
File size is 97 KB