DRAFT - Septic Tank Replacement Construction Permit

Septic Tank Replacement Construction Permit
The size and use of the septic tank and drainfield need to be determined before any work commences.
1. Contact TriCounty Health Department for records of the existing on-site wastewater system.
2. Fill out the following application completely.
3. You will need the size and manufacturer of the septic tank to be installed.
4. Install according to the manufacturer's instructions.
5. The new septic tank can be buried to the outlet.
6. The size and manufacturer information imprinted on the tank must be exposed.
7. Manholes on the tank must be accessible for inspection.
8. The septic tank must pass a leak test prior to covering.
9. $100 fee is required (non-refundable and subject to change)
Click link to view complete list of Waste Water Contractors and Installers

Date

MonthDayYear
Date
Property Serial Number*
Property Address of Waste Water Site *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Are you the current property owner?
Applicant Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email
example@example.com

Is the System Installer the same as the applicant?*
System Installer*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email
example@example.com

Septic Tank Size:*
Septic Tank Manufacturer*
Upload the following
Official floor plan of each level of the building*

Cancelof
Current Tax ID form (if there is no health department record)

Cancelof

Fee

Septic Tank Replacement Fee

$100.00 Quantity

Total

$0.00

Credit Card

The property owner has the ultimate responsibility for the design, installation, operation, and maintenance of the onsite wastewater system.
Property Owner Signature*

Clear
Should be Empty: