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Urbana & Champaign Sanitary District Forms
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Application for Connection Permit
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Urbana & Champaign Sanitary District
(217) 367-3409 Fax (217) 367-2603
- Complete information requested in Section 1-6, 9 & 10. Submit by email, online, fax, or deliver to the UCSD office. UCSD will fax the permit authorization and inspection form to the appropriate Municipality's inspection department. The Installer can pick up the permit at that office. UCSD will process applications received before 12:00 noon by 4:00 pm that day, after 12:00 noon by 12:00 noon the following day.
New Connection Permits
- Complete information requested in all Sections 1-10. Email, fax, or deliver to UCSD office. Pay the required connection fee and pick up permit at UCSD's office between 8-10 AM and 2:30-4:30 PM. Allow 24 hours for permit processing. Fee questions? Email: Permits@u-csd.com. The fee increases May 1st of this year.
For Office Use Only
Parcel # _______-_______-_______-_______-_______
1. Permit Type
2. Property Owner
Owner's Email Address
3. Owner Address
5. Jobsite Address
6. Subdivision & Phase
7. Property Use
8. Describe Use
9. Storm water drainage provided for building
Check all that apply
For each item checked, indicate where water is discharged
I hereby certify that information supplied is true, completed and accurate to the best of my knowledge.
10. Owner/Installer Name
For Office Use Only
Municipality: ___________ Permit No: _____________ Date Issued: ___________
Sewer Connection: Interceptor ______ Lateral ______ Use Code _______
Connection Units: P.E. ______ Amount Paid _______________ Check # _____
Manhole Policy: Yes _____ No _____ Interceptor Tap Policy: Yes _____ No _____
Repair Permit Authorization: _____________________ Date: _________________
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