Nebraska Department of Health and Human Services Post-Construction Form

Post-Construction Projects require the information below and submission of the following documentation:

Facility/Pending Facility Name Required

Facility/Pending Facility Address (City/Street/County) Required

Facility/Pending Facility Type Required

Project/Phase Name (NOTE: Names must match on all documentation for both PRE- and POST-Construction) Required

Please upload and attach the following documents:

Attachments - Total file size for all files cannot exceed 17 MB. Pdf, doc, docx, jpg, png, gif, and tiff formats are preferred.

Completion Certificate
Required

Occupancy Approval (Copy of the current inspection by the State Fire Marshal or their delegated authority approving the project area for public use)
Required

Floor Plan/Schematic Drawing (Simple drawing identifying key areas of the facility/project –including hand washing stations, restrooms, shower facilities, fire stations, etc. NOTE: This is not the same as the actual construction plans.)
Required

Bed Count List (ONLY REQUIRED if the number or location of beds has changed as a result of this project)

Zoning Approval

Printed name/contact information of facility person submitting form Required

Email Address Required

Phone Required

Security Authentication Required

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