Septic Permit Application

FORM – English

Required Contact Information




SEPTIC SYSTEM PERMIT APPLICATION






***The following questions are not applicable if only applying for a renewable operating permit***

What is the anticipated depth of the lowest floor below natural grade:

Will the building have:
Basement
Crawlspace
Slab on grade

If residential, how many bedrooms will the home have (unfinished basement = 1 additional bedroom):

If commercial, what is the anticipated maximum daily wastewater flow (gallons per day):

If a public water system is to be used, has a connection been approved for the proposed building:

If a private well/spring is to be used, what is the water right number or date right was applied for:

Application Signature

I certify that the information given is true and correct to the best of my knowledge

Septic Fees

Site feasibility - $100

Residential septic permit - $150

The permit fee total does not include fees for alternative technology septic permits and/or non-residential uses.