Forms & Licensing

Business Group Business Type Form Name Form
Campgrounds Campgrounds
  • Campground Registration
Campground Registration Form
Construction & Septic Construction
  • B100a Form (addition/shed/pool/etc)
  • Sample Plot Plan
Construction Forms
Construction & Septic Demolition
  • Demolition Requirements Form 1-08
  • DPH Demolition Notification Form
Demolition Forms
Construction & Septic Septic – New / Renovation
  • Septic application -New or Renovation
  • Application for Septic System, Site Plan, and Subdivision Plan Review
  • Application for Septic System Inspection and Certification
  • Notarized Statement for Homowner to Install
  • Operation and Maintenance of a Subsurface Sewage Disposal System
Septic Forms
Construction & Septic Water Treatment Waste Water
  • Application for the Installation of a Water Treatment Wastewater System (WTW)
Application for the Installation of a Water Treatment Wastewater System (WTW)
Daycare
  • Daycare Inspection Request form rev 1018
Daycare Inspection Request form rev 1018
Food Service Forms Food Service Renewal

Food Establishment’s Renewal Paperwork

  • Food Service License Application
  • Employee Training Record
  • Designated Alternate Form
  • Food Service Form 1-B
Food Establishment’s Renewal Paperwork
Food Service  Food Service 
  • Food Service License Application - revised 2018
  • Food And Safety Training (FAST) Class
  • FS Plan Review Application, renovations to existing-10-2016
  • Alternate Person In Charge Demonstrated Knowledge Statement
  • FS FORM 1-B
  • Employee Training Record
  • Guideline for Classifying Food Service Establishments
  • Fee Schedule
  • Choking Poster - English
  • Choking Poster - Spanish
  • Chinese Training Forms
  • Hot Food Holding Log
Food Service Forms
Food Service  Temporary Event 
  • Temporary Event
Temporary Event Application
Group Home 
  • Request for an Inspection of a Group Facility
Request for an Inspection of a Group Facility
Public Pools
  • Public Swimming Pool Registration Form
  • Disinfectant Levels
  • Daily Log Sheet for Swimming Pool
Public Pools Forms
Salon
  • Salon Application to Operate a Salon or Barbershop
  • Salon Review Application for a Salon or Barbershop
  • Salon Regulations
  • Salon Floor Plan Template
  • Salon Disinfection Guide
Salon Forms
Tattoo Facility
  • Tattoo Facility NEW Registration Form
Tattoo Facility NEW Registration Form

UNCAS

Fee Schedule
  • UNCAS Health District Fees Schedule
UNCAS Health District Fees Schedule
UNCAS FORMS
  • Uncas Health District Employment Application
  • UNCAS Request For Public Info
UNCAS FORMS

Main Location
Campbell Building
401 W. Thames Street, Suite 106
Norwich, CT 06360

Office Location
Park in the back of the Campbell Building
Enter through Credit Union entrance

Campbell Building Directions

Contact Us
Our main office is available Monday - Friday 8:00 am - 4:00 pm for all of the residents in our district.

p 860-823-1189
f 860-887-7898
e doh@uncashd.org

For Contact Information & Directions For All Locations

Norwich (main location), Jewett City, Lebanon, and Montville