Fee Schedule
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Applications
These forms may be completed on-line, however, they cannot be submitted via e-mail due to the fact that all applications and forms require original signatures. If you complete the form on-line, you must print the form and mail it to the address below.
Fees (if applicable) are payable to the "Licensure Unit".
Licensure Unit
PO Box 94986
Lincoln, NE 68509-4986
Click here for the application for Water Operators, or contact:
Doug Woodbeck, Program Manager
Phone: (402) 471-0521
E-mail: doug.woodbeck@nebraska.gov
Duplicates/Reissue Form
Name Change Form
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Renewal
- All licenses expire December 31st of every odd year.
- To renew a license, the license holder must submit the completed renewal application, obtain 10 hours of continuing education and pay the licensure fee.
- Renewal fees are the same as the initial licensure fees.
- A renewal notice will be sent to the last known address of record at least 30 days prior to expiration.
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Reinstatement
An individual whose credential has expired, been placed on inactive status, voluntarily surrendered unrelated to discipline, may apply for reinstatement at any time. The applicant must:
1. Submit a completed reinstatement application;
2. Obtain 10 hours of continuing education within the preceding 24 months;
3. If the licensee does not have the continuing education hours, she/he will need to successfully complete the applicable Grade Licensure examination.
4. Pay the fee(s):
· If the credential is expired, inactive, lapsed or non-disciplinary revocation, the reinstatement fee of $35 and the renewal fee; or
· If the credential was voluntarily surrendered, the renewal fee.
An individual whose credential was suspended or limited may apply for reinstatement at any time. An individual whose credential has been revoked may apply for reinstatement after a period of two years has elapsed from the date of revocation. An individual whose credential was voluntarily surrendered may apply for reinstatement according to the order entered by the Director. To apply for reinstatement, the individual must contact Nebraska’s Public Water Supply Program for further direction. (402-471-0521)
Continuing Education
Ten hours of approved continuing education are required for renewal of your license. Licenses are renewed every odd year. These credits must have been earned between the effective date of the license and 12/31 of the year of expiration. Hours completed prior to this time will not be accepted as meeting the required continuing education hours. Hours earned in excess of the requirement may not be carried over to the next renewal period.
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Name and Address Change
To request an address change, you can contact Patti Owens at (402) 471-2299 or e-mail patricia.owens@nebraska.gov
If you wish to change your name on your licensing record, you must mail a
written request with your signature notarized along with a copy of the legal document verifying name change to:
Licensure Unit
Water Operators
PO Box 94986
Lincoln, NE 68509-4986
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Duplicates/Reissue
Duplicates: A duplicate large license or small license card may be requested at the time of initial licensure.
A duplicate large license or small license card may be requested at the time of initial licensure. Reissue: A large license and/or small license card may be reissued when the licensee requests: additional documents; replacement of original document(s) due to loss, mutilation or destruction; or replacement of document(s) due to a name change.
A large license and/or small license card may be reissued when the licensee requests: additional documents; replacement of original document(s) due to loss, mutilation or destruction; or replacement of document(s) due to a name change. The Department will charge a fee of $10.00 for a duplicate of an original or reissued certificate.
To request a reissued license, you must submit a
request for reissuance to:
Licensure Unit
Water Operators
PO Box 94986
Lincoln NE 68509-4986
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Certification and Verification information can be obtained by checking the website at: www.dhhs.ne.gov/lis/lisindex.htm
OR
To request either a certification or verification or your license to be sent to another state licensing agency, send your request in writing along with the proper fee to the our office. Checks should be made payable to the Licensure Unit.
Certification
- Fee - $25.00
- Certification includes:
- Name
- Profession
- License number
- Issuance date
- Expiration date
- Whether the license was granted by examination, waiver, or reciprocity
- Examination information, if available
- Whether disciplinary action has been taken against the license. If so, the type(s) and date(s) of the action will be included.
- SEAL of the Nebraska Department of Health & Human Services
Verification
- Fee - $5.00
- Verification includes:
- Name
- Profession
- License Number
- Expiration Date
- Department Staff Signature
A verification does not include the SEAL of the Nebraska Department of Health & Human Services nor information relating to discipline, or examination.
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Rules and Regulations/Statutes
Regulations Relating to Operator Licensure - 179 NAC 10
Statutes Relating to Nebraska Safe Drinking Water Act
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Contact Us
Office Address: