Form DEP 4015, Application for Construction Permit, Onsite Sewage Treatment and Disposal System (OSTDS) Completed Form Examples and Samples
Explore detailed examples and filled samples of Florida's Form DEP 4015, the Application for Construction Permit for an Onsite Sewage Treatment and Disposal System (OSTDS). Our guide provides clear, completed templates to help you accurately fill out your septic system permit application for new systems, repairs, and modifications.
Form DEP 4015 Example – New Single-Family Residence
How this form was filled:
This is an example of a completed Florida Form DEP 4015 for a new single-family residence. It shows the application for a construction permit for a conventional onsite sewage treatment and disposal system (OSTDS), including property details, system specifications, and applicant information.
Information used to fill out the document:
- Application Type: New System
- Applicant Name: Jane Smith
- Applicant Phone: 555-123-4567
- Applicant Email: [email protected]
- Property Owner: Jane Smith
- Property Address: 123 Oak Lane, Orlando, FL 32801
- County: Orange
- Parcel ID Number: 12-34-56-7890-12-345
- Lot Size: 1.5 Acres
- Building Type: Single-Family Residence
- Number of Bedrooms: 4
- Water Supply: Private Well
- Proposed System Type: Conventional System
- Septic Tank Capacity: 1200 Gallons
- Septic Tank Material: Concrete
- Drainfield Type: Standard Trench
- Drainfield Size: 600 sq. ft.
- Site Evaluator: John Doe, P.E. #12345
- Septic Contractor: Reliable Septic Services Inc., License #SR0987654
- Application Date: 2026-05-10
What this filled form sample shows:
- Clearly specifies the application is for a New System for a Single-Family Residence.
- Includes complete and accurate property identification with Parcel ID and legal address.
- Details the proposed OSTDS specifications, including a 1200-gallon tank and a 600 sq. ft. drainfield.
- Provides information for both a certified Site Evaluator and a registered Septic Contractor.
- Correctly filled owner and applicant information, with a current signature date.
Form specifications and details:
| Form Name: | Form DEP 4015, Application for Construction Permit, Onsite Sewage Treatment and Disposal System (OSTDS) |
| Use Case: | New construction permit for a single-family residential septic system |
| Jurisdiction: | Florida Department of Environmental Protection (DEP) / County Health Department |
| System Type: | Conventional OSTDS |
Created: March 07, 2026 01:36 AM
